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Objective: Airway replacement is a challenging surgical intervention and remains an unmet clinical need. Due to the risk of airway stenosis, anastomotic separation, poor vascularization, and necrosis, it is necessary to establish the gold-standard outcomes of tracheal replacement. In this study, we use a large animal autograft model to assess long-term outcomes following tracheal replacement. Methods: Four New Zealand White rabbits underwent tracheal autograft surgery and were observed for 6 months. Clinical and radiographic surveillance were recorded, and grafts were analyzed histologically and radiographically at endpoint. Results: All animals survived to the endpoint with minimal respiratory symptoms and normal growth rates. No complications were observed. Computed tomography scans of the post-surgical airway demonstrated graft patency at all time points. Histological sections showed no sign of stenosis or necrosis with preservation of the native structure of the trachea. Conclusion: We established benchmarks for airway replacement. Our findings suggest that a rabbit model of tracheal autograft with direct reimplantation is feasible and does not result in graft stenosis or airway collapse. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Incessant Ventricular Tachycardia is a condition characterized by multiple episodes of Ventricular Tachycardia (VT) in 24 hours, persisting despite efforts to stop the arrhythmia. In this condition, sympathectomy as the surgical procedure is considered a permanent intervention and the last resort when medications prove ineffective. This procedure comprises the cutting or clamping of sympathetic nerves to prevent the transmission of nerve signals. Therefore, this study aims to present a case report of post-sympathectomy nursing management in a patient with Incessant Ventricular Tachycardia. Case Presentation: A 59-year-old female patient was admitted to the high-care unit with a diagnosis of post-sympathectomy, Incessant Ventricular Tachycardia due to Arrhythmogenic Cardiomyopathy. Nursing problems based on NANDA included decreased cardiac output, gas exchange impairment, and activity intolerance. Furthermore, the nursing interventions for the condition included self-care management and collaboration with an anesthesiologist and cardiologist. The interventions encompassed cardiac care, airway management, and activity therapy. Tele-nursing was also conducted through video calls to monitor the patient after hospital care. Results: The planned nursing care was effective in preventing common complications that often occur after the surgical procedure. The most important key aspect is regular maintenance and monitoring. The patient was discharged on the third day after the surgery with no complaints of shortness of breath, palpitations, and gradual resumption of activities. Conclusion: Sympathectomy procedures could successfully be used to treat patients through multidisciplinary collaboration. Furthermore, nurses could emphasize post-operative care management to expedite recovery and improve patient quality of life. [ABSTRACT FROM AUTHOR]

Transurethral resection of the prostate (TURP) is a surgical procedure often used to treat benign prostatic hyperplasia. TURP often results in multiple symptoms that worsen a patient's condition, such as hyperglycemia. The relationship between TURP and hyperglycemia is not direct, but it is important to consider the potential impact of hyperglycemia on individuals undergoing TURP. The most critical point in the TURP syndrome is early diagnosis and treatment. Nurses should be aware of the symptoms to prevent further outcomes. To optimise the nursing care, integrating of symptoms management model in TURP care is important as it provides a conceptual foundation for understanding patient care, guides clinical decision‐making, contributes to evidence‐based practice and fosters professional development. Also nurses can deliver high‐quality TURP and hyperglycemia care that meets the diverse needs of patients and contributes to positive health outcomes. However, a study describing the symptoms management of patients living with TURP syndrome and hyperglycemia is limited. Therefore, the article aims to explain the management of hyperglycemia among patients after TURP. The findings of this review are expected to help the nurses notice the symptoms and make accurate interventions along with evaluations. [ABSTRACT FROM AUTHOR]

This study investigated trends within a custom Sports Nutrition Assessment for Consultation (SNAC) survey designed to identify nutrition-related risk factors among post-operative lower-extremity youth athletes. Athletes aged 8–18 years who completed the SNAC at a sports medicine institution after lower-extremity surgery were reviewed for associations between SNAC questions and age/sex differences. Of 477 patients (15.0 ± 2.0 years; 47.8% female), 319 (66.9%) answered 'yes' to at least one question and were identified for a consult, though 216 (64.3%) declined. The most frequent questions to prompt a consult were a desire to better understand nutrition for recovery (41.5%) and regularly skipping at least one meal a day (29.8%). Inter-question responses were often significantly related, especially regarding appetite changes, weight changes, and/or meal-skipping. While consult acceptance was not significantly different between sex/age, males were more likely to report a desire to better understand nutrition (p = 0.004) and a weight change (p = 0.019), and females were more likely to report struggling with dizziness/fatigue (p < 0.001). Additionally, older athletes reported an appetite change (p = 0.022), meal-skipping (p = 0.002), a desire to better understand nutrition (p < 0.001), a weight change (p < 0.001), and an effort/recommendation to change their body composition/weight (p = 0.005). These findings demonstrate a link between risky nutrition behaviors and physical detriments. [ABSTRACT FROM AUTHOR]

Aim: To understand the experiences of individuals who undergo LEA due to DFU after disability. Design: A descriptive research design in qualitative research. Methods: Semi‐structured interviews were used in this qualitative descriptive study. Eleven middle‐aged patients (45–59 years) who underwent LEA due to DFU were purposively selected and interviewed. Qualitative data were thematically analysed. Results: Three themes and 10 subthemes were identified. The themes were (1) role function confusion, (2) self‐concept stress and (3) unreasonable objective support. Subthemes included (1) weakened career role, (2) family role reversal, (3) social role restriction, (4) over‐focusing on appearance, (5) immersion in patient experience, (6) living with faith, (7) polarization of independent consciousness, (8) low perceived benefits of peer support, (9) existence of treatment disruption and (10) poor participation in medical decision‐making. [ABSTRACT FROM AUTHOR]

The objective of polypectomy, a frequent endoscopic procedure, is to prevent colorectal cancer. Consequences of postpolypectomy care include minimizing complications, ensuring patient recovery, and preventing polyp recurrence. Besides monitoring polyp recurrence rates, this study assessed the effectiveness of post-polypectomy care protocols in managing patient comfort, adherence to dietary guidelines, and satisfaction with care. A cross-sectional analysis of 135 patients who underwent polypectomy at a tertiary care center was utilized in this study. Patient satisfaction, dietary adherence, postoperative comfort, and demographics were evaluated at one, three, and six months following the procedure. Recurrence of the polyp was monitored for one year. The research identified noteworthy enhancements in patient-reported comfort (P < 0.05), dietary adherence (P < 0.05), and overall satisfaction with care (P < 0.05). Additionally, complications such as infection (3.7%), bleeding (7.41%), and adherence to a prescribed diet decreased equivalently. Despite this, a trend toward increased polyp recurrence was observed that was not statistically significant, with rates increasing from 4.44% after three months to 12.59% after one year. Amid a gradual decline in dietary recommendation adherence, patient satisfaction with care remained consistently elevated. The results indicated that although prompt post-polypectomy care effectively improves patient comfort and satisfaction, long-term dietary adherence presents obstacles. Despite lacking statistical significance, the rising incidence of polyp recurrence emphasizes the criticality of diligent long-term surveillance. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your awareness of craniopagus, a rare condition in which identical twins are joined at the head • To identify the multidisciplinary skills and expertise required for successful separation of craniopagus twins • To explore the pivotal role of nurses in the management and care of craniopagus twins in hospital. Craniopagus is a rare condition in which the skulls of conjoined twins, and the neurovascular structures in their skulls, are incompletely separated. Separation surgery is complex and requires a range of skills and expertise, including from all the nursing teams involved. A multidisciplinary group of professionals in a tertiary paediatric care setting in Italy developed a comprehensive protocol for the nursing care of craniopagus twins in hospital, informed by the findings of a literature review and the expertise of its members. The protocol was applied to the management of a pair of craniopagus twins who successfully underwent separation surgery at the authors’ hospital. The protocol describes the crucial role of nurses in the care of craniopagus twins and their families before, during and after separation surgery. [ABSTRACT FROM AUTHOR]

Introduction: Hip fractures globally are associated with high levels of morbidity, mortality, and significant financial burden. This audit aimed to assess the impact of orthogeriatric liaison care on post-operative outcomes following surgical management of neck or femur fractures. Methods: Here, 258 patients who underwent hip fracture surgery over 1-year were included. Data were collected as an audit following the transition to an orthogeriatric liaison care model, involving regular orthogeriatric review (thrice weekly ward rounds, daily board rounds), superseding orthogeriatric review as requested. The audit is meant to assess the development of post-operative non-surgical site infection (NSSI) and mortality and duration of inpatient stay. Outcomes were compared to previous data from our hospital site in 2015/2016. Results: Patients with severe cognitive impairment and systemic disease (Abbreviated Mental Test Score (AMTS) < 7 and American Society of Anesthesiologists (ASA) grade ≥ 3) showed significantly elevated NSSI risk, consistent across the study periods. Both periods demonstrated an increased risk of NSSI associated with admission from nursing homes. Despite the 2021/2022 cohort being notably older, NSSI risk decreased from 40.6% to 37.2% after implementing the orthogeriatric care model. NSSI risk was notably reduced for severe cognitive impairment (51.6% vs. 71%), and the p-value was 0.025. Average hospital stay decreased post-intervention (2.4 days shorter), with a notable reduction for NSSI patients (3.4 days shorter). Overall mortality rates were similar, although mortality due to infection was significantly reduced in 2021/2022 (44.4% vs. 93.3%), and the p-value was 0.003. Conclusion: The orthogeriatric liaison care model significantly decreased NSSI only in individuals with severe cognitive impairment and infection-associated mortality. This highlights the integral role of orthogeriatricians in the care of elderly hip fracture patients. [ABSTRACT FROM AUTHOR]

Urinary retention is a common post‐operative complication in the older patients. The use of hot and cold compresses can be considered a safe and non‐invasive method to relieve urinary retention. In this study, the effects of these two methods are compared. In this randomised clinical trial study, 52 older patients with urinary retention underwent general surgery in two groups underwent local intervention of hot and cold water compresses. After the intervention, success in relieving retention and the exact duration of urine flow were measured and recorded. The mean age of the hot compress group was 69.38 ± 7.82 and the cold compress group was 68.96 ± 7.28 years and the majority of both groups were male. The mean duration of post‐operative urinary retention was not significantly different between the two groups. Urinary retention was eliminated in 46.2% of patients in the hot compress group and 53.8% in the cold compress group without the need for catheterization. This difference was not statistically significant (p = 0.782). The duration of urination after compression did not show a statistically significant difference between the two groups. Due to very little research on the use of cold compresses in relieving urinary retention, the findings of this study showed that the success rate of cold compresses in relieving retention was slightly higher than hot compresses. Therefore, this type of compress can also be used to relieve retention. [ABSTRACT FROM AUTHOR]

Due to the global increase in thoracic interventions, there is greater emphasis on refining post‐operative care. The purpose of this study was to validate the visual analogue scale (VAS) as the valid method for measuring post‐operative pain in thoracic surgery patients. From January 2020 to June 2022, this cross‐sectional study investigated 240 adult patients who underwent elective thoracic surgeries in Thoracic Surgery Department of Heilongjiang Provincial Hospital. The participants were instructed to rate their discomfort using VAS at predetermined intervals after surgery. The following demographic and clinical information was recorded: age, gender, type of thoracic surgery, and history of chronic pain. Results showed a progressive decline in post‐operative VAS scores over 72 h: 8.2 immediately after surgery, 6.0 at 24 h, 5.4 at 48 h, and 3.6 by 72 h. There were notable correlations between VAS scores and chronic pain history, with moderately positive correlation of 0.40 being observed. Mean scores for males and females were 3.8 and 3.9, respectively. The analysis by age revealed comparable mean scores for age categories below and above 40. With the exception of thoracic wall resection, which resulted in an average VAS score of 4.1 ± 1.0 (p < 0.05), the type of surgery had the minimal effect on variability of pain scores. The VAS is a reliable method for evaluating post‐thoracic surgery discomfort. Given the substantial impact of pain history on VAS scores, there is an urgent need for personalized pain management strategies to improve post‐operative care. [ABSTRACT FROM AUTHOR]

Abstract Aim To understand the experiences of individuals who undergo LEA due to DFU after disability. Design A descriptive research design in qualitative research. Methods Semi‐structured interviews were used in this qualitative descriptive study. Eleven middle‐aged patients (45–59 years) who underwent LEA due to DFU were purposively selected and interviewed. Qualitative data were thematically analysed. Results Three themes and 10 subthemes were identified. The themes were (1) role function confusion, (2) self‐concept stress and (3) unreasonable objective support. Subthemes included (1) weakened career role, (2) family role reversal, (3) social role restriction, (4) over‐focusing on appearance, (5) immersion in patient experience, (6) living with faith, (7) polarization of independent consciousness, (8) low perceived benefits of peer support, (9) existence of treatment disruption and (10) poor participation in medical decision‐making.

Background: Cardiac rehabilitation is recommended for patients undergoing open‐heart surgery (OHS). During the hospital admission, these patients suffer from reduced cardiopulmonary performance and decreased psychological health, leading to poor physical function, depression, and morbidity. To prevent post‐operative pulmonary complications, a pre and post‐operative physical therapy intervention is recommended for patients undergoing heart surgery. Virtual reality (VR) promotes the health status of healthy individuals and those with health conditions. However, few studies have reported the beneficial effects of VR exercise programs on the pulmonary performance and mental health status of patients undergoing OHS. Objectives: To determine whether by using training enhanced by VR, patients who have undergone OHS can more effectively attain cardiopulmonary performance and improve depression than through conventional physical therapy. Method: 60 participants were randomly assigned to a conventional physical therapy and VR exercise program. Each session was conducted once daily until discharge from the hospital. Cardiorespiratory performance and depression were evaluated before surgery and at the time of discharge from the hospital. A two‐way mixed ANOVA was performed to compare within (i.e., pre and post‐operation) and between (i.e., VR and conventional physical therapy) groups. Results: No significant cardiopulmonary performance gains were detected in patients receiving the VR exercise program when compared with those who participated in conventional physical therapy prior to post‐operative OHS (p > 0.05). However, the conventional physical therapy group showed significantly higher depression scores than the VR group (∆4.00 ± 0.98 vs. ∆1.68 ± 0.92). However, cardiopulmonary performance did not differ in both VR exercise and conventional physical therapy. [ABSTRACT FROM AUTHOR]

Oral carcinoma, a prevalent malignancy of the oral cavity, often results in surgical site wounds post‐resection. The therapeutic efficacy of platelet‐rich fibrin (PRF) in wound healing and scar formation has garnered significant attention. This meta‐analysis aimed to evaluate the role of PRF in promoting surgical site wound healing and reducing scar formation following oral carcinoma resection. A systematic search, adhering to PRISMA guidelines, was conducted across multiple databases. The primary outcomes assessed were the Landry, Turnbull and Howley (LTH) wound healing index and the Manchester scar scale (MSS). Statistical evaluations were performed using RevMan 5.4 software. Six studies were incorporated, involving 93 patients treated with PRF and 97 in the control group. For the LTH index, significant improvements in wound healing were observed in the PRF group with I2 = 74%, (Random: SMD: 3.70, 95% CIs: 2.66 to 4.75, p < 0.01). The Manchester scar scale assessment, which included 60 PRF‐treated patients and 60 controls, indicated a significant reduction in scar formation in the PRF group I2 = 79%, (Random: SMD: 9.13, 95% CIs: 6.06 to 12.20, p < 0.01). PRF demonstrates promising therapeutic potential in enhancing surgical site wound healing and reducing scar formation post oral carcinoma resection. The application of PRF has been associated with improved wound healing metrics and diminished scar severity. However, further high‐quality studies are warranted to confirm these findings. [ABSTRACT FROM AUTHOR]

Purpose: We investigated bacterial propagation through multifilament, monofilament sutures and whether sutures coated with triclosan would exhibit a different phenomenon. Methods: One centimetre (cm) wide trenches were cut in the middle of Columbia blood Agar plates. We tested a 6 cm length of two Triclosan-coated (PDS plus®, Vicryl plus®) and two uncoated (PDS ®, Vicryl ®) sutures. Each suture was inoculated with a bacterial suspension containing methicillin-sensitive Staphylococcus aureus (MSSA), Escherichia coli (E. coli), Staphylococcus epidermidis, methicillin-resistant Staphylococcus aureus (MRSA) at one end of each suture. The plates were incubated at 36C for 48 h, followed by room temperature for a further 5 days. We established bacterial propagation by observing for any bacterial growth on the Agar on the opposite side of the trench. Results: Bacterial propagation was observed on the opposite side of the trench with both suture types, monofilament PDS and multifilament Vicryl, when tested with the motile bacterium (E. coli). Propagation was not observed on the other side of the trench with the monofilament PDS suture following incubation with MSSA and S. epidermidis, and in 66% of MRSA. With multifilament suture Vicryl, propagation was observed on the other side of the trench in 90% (MSSA), 80% (S. epidermidis), and 100% (MRSA) of plates tested. No bacterial propagation was observed in any of the triclosan-coated sutures (monofilament or multifilament). Conclusions: Monofilament sutures are associated in vitro with less bacterial propagation along their course when compared to multifilament sutures. Inhibition in both sutures can be further enhanced with a triclosan coating. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the challenges related to quantifying staffing requirements in a post-anaesthesia care unit (PACU) • To increase your understanding of the suitability of different types of data for quantifying PACU staffing requirements • To read about factors to consider when developing a model for quantifying PACU staffing requirements Nurse managers in charge of a post-anaesthesia care unit (PACU) face the task of optimising staffing levels and must be able to justify staffing needs to the wider operational team. The high variability in patient numbers and acuity that characterises the PACU, as well as the broader factors that affect patient flow to and from the PACU, make it challenging to quantify staffing requirements. Staffing models often fail to reflect accurately the needs of patients and therefore the needs of the unit and there is no recommended model for quantifying PACU staffing requirements. In this article, the author describes the challenges of quantifying PACU staffing requirements and the suitability of different types of data. The author also discusses factors to consider when developing model for quantifying PACU staffing requirements. [ABSTRACT FROM AUTHOR]

Objective: Surgical site infections (SSIs) are a major source of morbidity after cardiac surgery, involving prolonged hospitalisation. Among the numerous techniques of skin closure and dressings available, the optimal method remains undetermined. The DERMABOND-PRINEO (PRINEO) (PRINEO, Ethicon, J&J) is the only skin closure system which combines a topical skin adhesive with a mesh. Other surgical disciplines have highlighted remarkable results with PRINEO. The aim of this study was to evaluate the effects of PRINEO, used as the final layer in sternotomy closure, in the incidence of postoperative SSIs. Method: This was a retrospective single-centre cohort study including adult patients who underwent cardiac surgery between January 2015 and December 2018. Patients who had undergone heart transplantation or ventricular assist surgery were excluded. Included patients were divided into two groups depending on the type of post-operative wound care technique used. Group 1 consisted of patients who had their sternotomy closed with a standard dressing and group 2 consisted of patients who were treated with PRINEO. The primary endpoint of our study was the occurrence of SSIs and secondary outcomes were the length of hospitalisation and mortality. Results: A total of 1603 patients were reviewed with the occurrence of 44 SSIs. Both groups were homogeneous in terms of risk factors. The incidence of SSIs was significantly lower in group 2 (PRINEO) than in group 1 (standard dressing) (n=29, 3.8% vs n=15, 1.8%, respectively; p=0.042). However, there was no significant difference in the duration of hospitalisation and mortality. Conclusion: In our practice, PRINEO has proven to be a safe wound closure system after sternotomy, with a reduced SSI rate compared to conventional wound care techniques. [ABSTRACT FROM AUTHOR]

Background: Post-operative care is essential for optimal healing and reducing complications after endoscopic sinus surgery (ESS). Nasal irrigation with normal saline is commonly used, but budesonide nasal irrigation has gained attention for its anti-inflammatory properties. This study aims to compare the efficacy of budesonide nasal irrigation to normal saline nasal irrigation in post-operative ESS management. Methods: A randomized controlled trial was conducted, enrolling patients who underwent endoscopic nasal surgery. Participants were allocated into two groups: normal saline irrigation (Group 1) and budesonide irrigation (Group 2). The primary outcomes assessed were the SNOT-22 score (Sino-Nasal Outcome Test) and the Lund-Kennedy endoscopic score. Data analysis was performed using parametric and non-parametric tests. Results: The study included 41 patients in Group 1 and 44 patients in Group 2. In the first visit, Group 2 (budesonide) had a significantly better SNOT-22 score (p<0.0001) and Lund-Kennedy score (p=0.0034) compared to Group 1 (saline). In the second visit, Group 2 showed a significantly better SNOT-22 score (p<0.0001) and Lund-Kennedy score (p<0.0001) compared to Group 1. Conclusion: Budesonide nasal irrigation with a positive pressure high-volume device demonstrated superior efficacy compared to normal saline nasal irrigation in post-ESS management. These findings suggest that budesonide may be considered as a replacement for normal saline irrigation in future management protocols. [ABSTRACT FROM AUTHOR]

It is estimated that over 2.2 billion people globally have a visual impairment. Cataract is one such form of impairment, which can be surgically corrected. However, disruptions in ophthalmic services due to the pandemic have resulted in long wait times—estimated to take up to 5 years to clear. Considering these issues, there is no doubt that individuals affected by the condition will be negatively impacted. In this article, Penelope Stanford provides information on the anatomy and altered physiology of the crystalline lens, and informs on the essentials of patient care. [ABSTRACT FROM AUTHOR]

Background: Coronary artery bypass graft (CABG) is intended to restore myocardial perfusion and alleviate morbidity among patients suffering from coronary artery disease. Due to procedural complexity, and anesthetic medications, post-operative complications are more prevalent, requiring the integration of rehabilitation strategies. This review aimed to determine the effect of single and multiple exercise therapy on rehabilitation after CABG surgery. Methods: We conducted a systematic search of databases (EBSCOhost, Scopus, PubMed, and Web of Science) from 01 January 2000 to 15 September 2022. The protocol of this systematic review is registered to PROSPERO. Results: We found nine randomized control trials composed of 599 CABG patients. In-patient cardiac rehabilitation (CR), a combination of inspiratory muscle training, mobilization, active upper and lower limb exercise, and aerobic exercise as multiple exercise therapy, found significant improvement in 6-minute walking distance (6MWD) than single exercise therapy (breathing exercise) at discharge and follow-up (moderate quality evidence). Contrary, multiple exercises group compared to single exercise groups did not improve the peak volume of oxygen (VO2) at discharge. Still, significant improvement was found at follow-up (moderate quality of evidence). On the other hand, the out-patient CR made up of high-intensity inspiratory muscle training, upper and lower limbs resistance training, and aerobic exercise as multiple exercise therapy significantly improved 6MWD and peak VO2 at discharge (High-quality evidence). Conclusions: Our review revealed that multiple exercise therapy significantly improves functional and exercise capacity in in-patient and out-patient cardiac rehabilitation settings than single exercise therapy, but more than double exercise therapy protocol may be inefficient for improvement of quality of life. Inspiratory muscle training and resistance training in exercise therapy protocols significantly supplant the outcome, which requires further investigation. [ABSTRACT FROM AUTHOR]

Abstract Introduction Thirst is a powerfully distressing sensation that occurs most frequently in the immediate postoperative period. Postoperative thirst is prevalent, the moderate-to-severe type is estimated to affect 53.2–69.8% of patients and causes significant patient discomfort. Objective The objective of this study was to assess the prevalence, and factors associated with postoperative thirst among surgical patients in PACU at the University of Gondar Comprehensive Specialized Hospital from April 20 to June 27, 2021. Methods An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital. A total of 424 participants were included in the study. Statistical analysis had performed using SPSS 26.00 version statistical software. Binary logistic regression analysis was performed to identify the association between the prevalence of postoperative thirst and independent variables and only variables with p-value

Post-operative cures with hyaluronic acid (HA) could potentially shorten the period recovery involved in the phenol technique for ingrown toenail. The aim of this study was therefore to compare a standard healing protocol with the experimental one based on hyaluronic acid cream. 70 patients who had undergone phenol technique surgery for ingrown toenail were divided into two groups – control (n = 35) who received post-operative cures following the standard protocol with povidone iodine gel, and experimental (n = 35) who received cures with HA in the first 3 visits. Bleeding, total healing time, and perceived pain were assessed. Patients in the control group recovered from the intervention in a total of 26.17 ± 7.75 days, while those in the HA group recovered in a significantly shorter time – 22.42 ± 2.41 days (p = 0.007, effect size 0.653). However, there were no between-group statistical differences in bleeding or perceived pain over the course of the post-surgery visits. The use of low molecular weight hyaluronic acid is effective in reducing the phenol-technique healing time by 4 days compared with the standard cure. However, no extra effects such as reductions in bleeding or perceived pain can be expected in choosing this healing protocol. • Drugs with HA promote tissue regeneration and wound healing. • Post-operative cures with HA may reduce the recovery period in phenol technique. • Patients cured with HA recovered from the intervention 4 days before than controls. • However, no effects in bleeding or perceived pain can be expected using HA creams. [ABSTRACT FROM AUTHOR]

Knowing the risk factors for poor outcomes following hip fracture surgery is necessary for appropriate patient care. The objective of this study was to determine if the first post-operative visit (POV) following hip fracture surgery is a risk factor for increased mortality, complications, and re-admissions. This was a retrospective review of 285 patients who underwent operative fixation of a hip fracture at an academic acute care hospital. Outcome measurements were 90-day and one year mortality, 90-day complications, and 90-day re-admission rates in patients who missed or attended their first post-operative visit following hip fracture surgery. 279 patients met inclusion criteria and had sufficient data for analysis, of which 213 (76.3%) made their first post-operative visit. 90-day and one-year mortality were significantly higher in the patients who missed their first POV (31.8% vs. 4.2%; 51.5% vs. 12.7%). Independent risk factors for 90-day complications were missing the first POV, coronary artery disease, and lower pre-injury status (ORs = 10.65, 2.80, 7.89, respectively). Independent risk factors for 90-day re-admission were missing the first POV, chronic obstructive pulmonary disease on home oxygen, and lower re-injury status (ORs = 8.04, 5.44, 5.47, respectively). Missing the first POV was the strongest independent risk factor for 90-day complications and 90-day readmission. Patients who miss their first POV have significantly higher 90-day and one year mortality rates. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia, Cuidado e Saude is the property of Universidade Estadual de Maringa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Post‑operative care after functional endoscopic sinus surgery (FESS) is essential for managing the long‑term success of chronic rhinosinusitis. Post-operative sinus debridement promotes proper wound healing, but the procedure can be accompanied by discomfort and pain. Hence, we analysed the clinical factors related to sinus debridement time after FESS. Materials and Methods: We evaluated retrospectively the clinical factors affecting the time taken for post‑operative sinus debridement on the first visit after the discharge. We reviewed 101 patients who underwent FESS at our hospital by the same surgeon and extracted patient information. The time for post-operative sinus debridement at the first outpatient clinic was measured. Results: The days of putting the cotton ball in the operated nostril were negatively associated with sinus debridement time (coefficient – −16.4 ± 5.7 seconds/day, P = 0.005). In contrast, current or history of asthma, amount of bleeding during the surgery, number of opened sinuses by the operation or the number of eosinophils in resected tissues under a microscope at ×400 was not associated. Discussion: We recommend the use of a cotton ball in the nostril after FESS because it shortens the sinus debridement time. Placing cotton balls in the nostril helps to maintain a humid wound environment and reduce crusting, leading to easier sinus debridement and better wound healing. [ABSTRACT FROM AUTHOR]

Mobilisation is recommended following cardiac surgery, but much less is known about its effects on physiological parameters. This study aimed to determine the effect of mobilisation on cardiorespiratory physiological parameters, and to establish the relationship between physiological parameters and physical function following cardiac surgery. Participants requiring physiotherapy following cardiac surgery were recruited. Mobilisation involved ground-based walking, while physical function was assessed using the short physical performance battery (SPPB) test. During both procedures, physiological measures of heart rate (HR), respiratory rate (RR) and percutaneous oxygen saturation (SpO2) were periodically recorded. Participant perception of breathlessness and perceived exertion were recorded pre and post mobilisation and the SPPB test. Forty-five participants (mean [SD] age 69[7] years) completed the study. HR (mean difference 10[95% CI 8 to 12] bpm) and RR (13[10 to 17] br/min) significantly increased following mobilisation, while SpO2 significantly decreased (baseline median [IQR] 95% [95%–97%] vs nadir 94% [91% to 96%], p < 0.002). There was a significant increase in dyspnoea and perceived exertion (both p < 0.001). There was a moderate relationship between total SPPB score and SpO2 during mobilisation (rs=0.45). Mobilisation following cardiac surgery increases exertion and dyspnoea and alters physiological parameters. Greater physical function is linked to maintaining a higher oxygen saturation during mobilisation. [ABSTRACT FROM AUTHOR]

Objectives: Although total laryngectomy (TL) is a well-established surgical procedure with clear functional or oncologic indications, the peri- and postoperative care for those undergoing TL is variable, particularly regarding postlaryngectomy tracheostoma management. This study examined TL outcomes from a single institution with the immediate perioperative use of soft silicone laryngectomy tubes. More specifically, we explored potential complications associated with immediate perioperative use of a flexible laryngectomy tube (LaryTube and StomaSoft) and the use of heat and moisture exchange (HME) devices in association with peri- and postoperative care., Methods: A case series including all patients undergoing TL by one primary surgeon at a tertiary care hospital between 2006 and 2023 were assessed. Variables of interest included hospital average length of stay (LOS) in hospital, use of laryngectomy tube and an HME, primary tracheoesophageal puncture voice restoration at time of TL, discharge feeding, stoma-related complications, and overall complications., Results: Seventy-two patients were included over the study period, and all utilized a laryngectomy tube and HME in the perioperative period without complications. Fifty-six patients (77.7%) had concurrent neck dissections and nine (15%) underwent total laryngopharyngectomy. Sixty-two patients (86%) underwent TL for squamous cell carcinoma of the larynx or hypopharynx and 35 of these (56%) were salvage surgeries. Mean LOS was 8.4 (3-45) days, and 63 patients (88%) were discharged with nasal gastric tube feeding. Of the six patients (8%) who were readmitted for complications, zero (0%) were related to the laryngectomy tube or to stoma-related complications (e.g., dehiscence, infection, mucous plugging). No patient who utilized a laryngectomy tube and HME device in the perioperative period experienced stomal stenosis., Conclusions: Laryngectomy tubes combined with an HME can be employed safely and successfully in a high percentage of laryngectomy patients placed perioperative. No instances of postlaryngectomy tracheostoma stenosis occurred in association with perioperative laryngectomy tube with HME use. These collective data support the use of a laryngectomy tube with HME in the immediate perioperative period, with low risk of complications., (© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.)

Telemedicine (TM) use accelerated out of necessity during the COVID-19 pandemic, but the utility of TM within the pediatric surgery population is unclear. This study measured utilization, adequacy, and disparities in uptake of TM in pediatric surgery during the COVID-19 pandemic. Scheduled outpatient pediatric surgery clinic encounters at a large academic children's hospital from January 2020 through March 2021 were reviewed. Sub-group analysis examined post-operative (PO) visits after appendectomy and umbilical, epigastric, and inguinal hernia repairs. Of 9149 scheduled visits, 87.9% were in-person and 12.1% were TM. TM visits were scheduled for PO care (76.9%), new consultations (7.1%), and established patients (16.0%). Although TM visits were more frequently canceled or no shows (P < 0.001), most canceled TM visits were PO visits, of which 41.7% were canceled via electronic communication reporting the absence of any PO concerns. TM visits were adequate for accomplishing visit goals in 98.2%, 95.5%, and 96.2% of PO, new, and established patient visits, respectively. Patients utilizing TM visits were more frequently of white race, privately-insured, from less disadvantaged neighborhoods, and living a greater distance from clinic (P < 0.001 for all comparisons). TM was adequate for the majority of visits in which it was utilized, including the basic PO visits that occurred via TM. TM was used more by patients with greater travel and less by those of minority race, with public insurance, and from more disadvantaged neighborhoods. Future work is necessary to ensure broad access to this useful tool for all children requiring surgical care. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery (ERAS) has decreased hospital opioid use, but less attention has been directed towards its impact on clinic burden with respect to post-operative care. Our objective was to determine the impact of an ERAS protocol on post-operative opioid prescribing, and the subsequent number of pain medication refill requests and unscheduled patient-provider interactions in the 30-day post-operative period. IRB-approved retrospective study comparing post-operative opioid prescription practices 10 months before and 10 months after ERAS protocol implementation after minimally invasive gynecologic surgery. Opioid doses in morphine milligram equivalents (MMEs), number of unscheduled visits, and phone calls were compared before and after ERAS implementation. A total of 791 patients were included; 445 without and 346 with ERAS implementation. ERAS was associated with higher rates of same day discharge (49% vs 39%, p = 0.003) and lower readmission rates (2.0% vs 5.6%, p = 0.011). Post-operatively, patients who received the ERAS protocol were prescribed less opioids (197.8 vs. 223.5 MMEs, p = 0.0087). There was a trend towards less refill requests with ERAS (1.7% vs 3.6%, p = 0.11). ERAS was associated with a decreased number of post-operative phone calls (38% vs 46%, p = 0.023), including calls for pain (10% vs 16%, p = 0.021), and fewer unscheduled visits related to pain (1.5% vs 5.8%, p = 0.001). Implementation of the ERAS protocol resulted in a decrease in post-operative opioid prescribing. Despite the lower amount of prescribed post-operative opioids, the ERAS protocol translated into a decrease in the need for post-operative interactions with the clinic staff, specifically encounters associated with pain. • ERAS protocol is associated with a reduction in intra-operative opioid use and opioids prescribed for post-operative pain. • Lower doses of post-operative opioids following minimally invasive gynecologic surgery do not increase clinic staff burden. • Patients who receive ERAS protocol make less calls and visits related to pain despite lower doses of opioids prescribed. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: the use of telepresence grows with the advancement of technology integration into medical practice. Regarding surgery, effective distance communication can translate into better perioperative care. Though, the patients’ perception about this modality needs to be critically evaluated. Structured questionnaires using objective scales are the instruments of choice for measuring subjective aspects. However, there are no such questionnaires available in Portuguese. Our objective was, thus, translate and adapt into Portuguese a specific questionnaire evaluating the use of telepresence robots during post-operatory ward rounds. Methods: search on PubMed and selection of a set of validated questionnaires in English, translation into Portuguese according to the principles of good practice for the translation and cultural adaptation process for patient-reported outcomes measures. The original author approved the final version. Results: three questionnaires that assess ward rounds assisted by a telepresence robot were translated. Questionnaires are directed to the patient who receives the visit via telepresence or face-to-face visit and to the medical team accompanying the visit. The questionnaires use the Likert scale and contain thirteen questions that address 5 spheres: Communication; Dignity and Confidentiality; Contents; Time; General Impressions. Conclusions: this is the first instrument in Portuguese designed to assess the impression of patients and professionals involved in ward rounds using a telepresence robot. It has the potential to be used in clinical studies involving the use of this technology in care.

Mastectomy is mostly performed as definitive management for resectable breast cancer (BC). Implementing paravertebral nerve block for patients with metastasis features of cancer to lungs and other organs, patients with co-morbidity, geriatrics and malnourished individuals will eliminate the risks and complications of general anaesthesia (GA). Although thoracic paravertebral block is an established technique as post-operative pain management for breast surgery, there is no conclusive evidence on its use as a sole anaesthetic for modified radical mastectomy (MRM). In this case report, we present a 45-year-old woman who underwent a successful MRM for Stage IIIb BC associated with pulmonary tuberculosis with moderately restricted pulmonary function test under paravertebral nerve block. We believe that paravertebral nerve block can be used as an alternative anaesthetic technique for MRM in a resource-limited setting for patients who are expected to have a high risk of perioperative complications under GA.

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Introduction: Thirst is a powerfully distressing sensation that occurs most frequently in the immediate postoperative period. Postoperative thirst is prevalent, the moderate-to-severe type is estimated to affect 53.2–69.8% of patients and causes significant patient discomfort. Objective: The objective of this study was to assess the prevalence, and factors associated with postoperative thirst among surgical patients in PACU at the University of Gondar Comprehensive Specialized Hospital from April 20 to June 27, 2021. Methods: An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital. A total of 424 participants were included in the study. Statistical analysis had performed using SPSS 26.00 version statistical software. Binary logistic regression analysis was performed to identify the association between the prevalence of postoperative thirst and independent variables and only variables with p-value < 0.2 were entered into the multivariable analysis. The strength of the association was presented by odds ratio and 95% Confidence interval. P-value < 0.05 was considered statistically significant. Result: The prevalence of postoperative thirst among postsurgical patients was 59% (95% CI = 54.74–64.13). Inadequate preloading (Adjusted odes ratio (AOR) = 2.137 95% CI 1.260–3.624), prolonged Nil Per Os (NPO) time (AOR = 13.80 95% CI 2.93–65.37), general anesthesia (AOR = 3.90 95% CI 3.56–11.25), and axillary body temperature ≥ 37.5 °C (AOR = 8.07 95% CI 3.63–17.96) were significantly associated with postoperative thirst. Low room temperature (< 20 °C) was protective for the occurrence of postoperative thirst (AOR = 0.162 95% CI 0.37–0.707). Conclusion and recommendations: The prevalence of postoperative thirst remains high and need commitment in close monitoring of PACU patients and immediate intervention. We also urge that high-level, ongoing research be conducted in this area, as postoperative thirst is a very common problem with a lot to discover. [ABSTRACT FROM AUTHOR]

Introduction and objective: Due to the high cost and insufficient offer, the request for Intensive Care (ICU) beds for postoperative recovery needs adequate criteria. Therefore, we studied the characteristics of patients referred to postoperative care at an ICU from the perspective of anesthesiologists, surgeons, and intensive care physicians. Methods: A questionnaire on referrals to postoperative intensive care was applied to physicians at congresses in Brazil. Anesthesiologists, surgeons, and intensive care physicians who agreed to fill out the questionnaire were included. The questionnaire consisted of hypothetical clinical scenarios and cases for participants to choose which would be the priority for referral to the ICU. Results: 360 physicians participated in the study, with median time of 10 (5–18) years after graduation. Of the interviewees, 36.4% were anesthesiologists, 30.0% surgeons, and 33.6% intensive care physicians. We found that anesthesiologists were more conservative, and surgeons less conservative in ICU referrals. As to patients with risk of bleeding, 75.0% of the surgeons would refer them to the ICU, in contrast with 52.1% of the intensive care physicians, and 43.5% of the anesthesiologists (p