Coffee water extract strongly inhibits many Gram (+) and Gram (-) bacteria. In experimental wound healing in rats, coffee grounds healed wounds quickly. Its robust antibacterial, antioxidant, and anti-inflammatory perfect for wound healing. The clinical application of coffee grounds for acute and chronic wounds is a safe, compliant, simple, non-allergic, pleasant aroma, and uncomplicated. A thin layer of coffee grounds remains on the wound during replacement to ensure the superficial cells multiply safely and prevent cell manipulation. Debridement and dressing replacement perform rarely. It resulted in practical and faster wound healing and acceptable scarring. The method is called the New Paradigm of wound management. The coffee ground for wounds drives public health strengthening in wound care, promotes patient-centered care, and humanizes humans.
Morbid obesity is a growing problem affecting millions of Americans. Bariatric surgery is an effective method to combat obesity in those who have failed diet and exercise attempts. Unfortunately, some patients do not experience satisfactory weight loss after bariatric surgery. We are currently trialing shortening of the common channel as a method for weight loss in patients who have previously undergone Roux-en-Y gastric bypass. Our aim is quantify the weight loss after shortening of the common channel to determine if it is a satisfactory method of further weight loss after Roux-en-Y gastric bypass. Between 2020-2021 we had 16 patients who underwent shortening of the common channel. Weight loss, body mass index (BMI) and excess weight loss (%EWL) were recorded at 3,6,9 and 12 months postoperatively. The mean weight prior to shortening of the common channel was 238 lbs ± 29. BMI prior to shortening of the common channel was 41 kg/m2 ± 4. Patients in the study lost 14 lbs (n=10), 28 lbs (n=9), 40 lbs (n=6) and 57 lbs (n=4) at 3, 6, 9 and 12 months respectively. At 9 months and beyond, patients experienced an 11-point reduction in their BMI, from an average BMI of 41 kg/m2 preoperatively to 29.5 ± 5.6 (n=8). After 9 months patients had a 75% reduction in excess weight. Currently many patients are still undergoing their routine follow up, as their procedures occurred less than a year ago. One patient unfortunately passed away due to consequences of malnutrition secondary to bariatric surgery. Another patient had to receive supplemental nutrition via tube feeds through the gastric remnant. Currently, shortening the common channel offers reasonable weight loss in patients who have unsatisfactory weight loss post gastric bypass but care should be taken as there is a high risk for malnutrition. Further follow-up is needed to continue to evaluate long-term weight loss in these patients and to monitor for malnutrition in subsequent years.
Introduction: UK melanoma incidence is continuing to rise, resulting in a growing economic burden to the NHS and wider economy. Public awareness campaigns have aimed to tackle this issue, yet the real-world impact on the UK population is poorly understood. Google Trends is a tool that identifies search interest patterns by keywords, incidence and geography. The study aim is to characterise UK and international search trends for skin cancer, tanning methods and sun protection. Methods: Google Trends was systematically searched using terms associated with artificial UV tanning, sun protection and skin lesions, including cancer. The searches compared the UK to Australia and the USA (2004-2018). Results: Search terms of artificial UV tanning (“sunbed”, “tanning bed” and “tanning salon”) peak annually during May, whereas the highest volume of searches for sun prophylaxis (“sun cream”, “sunscreen”, “sun protection”) and skin lesions (“mole”, “skin cancer”) occurs during June. Troughs appear from November to January. Australia and the USA’s sun protection searches occur before summer peaks. Conclusions: Skin cancer-related searches occur on a predictable cycle, peaking during summer and declining over winter. The UK interest in tanning peaks during late spring/early summer, not traditionally targeted for campaigning, whilst skin cancer searches peak mid-to-late summer. This is likely post-sun damage. Australians search for skin cancer advice in their spring, supporting their well-studied culture of skin cancer awareness. These lessons can inform UK health policy. Google Trends is useful for characterising search interest, which may reflect public awareness.
Breast reconstruction has been a hot topic for decades. With rapidly evolving reconstruction techniques, higher standards of quality have been achieved. One of the current gold standard breast reconstructions at the moment is autologous breast reconstruction. The choice of the recipient vessels in microsurgery reconstruction has been a topic of fierce debate. With proponents and opponents of each recipient vessels option justify their choice. One of the most debatable topics is the use of the IMA perforators as recipient vessels in microsurgery for breast reconstruction. In this article we address the pros and cons plus myths and dogma about using the IMA perforators as the recipient vessels in breast reconstruction.
Background: Day of surgery admission, rather than inpatient surgery, is increasingly being considered the norm for all patients undergoing elective surgery, rather than simply an alternative form of treatment for a few. However, it is also important to recognize that the model of provision should be geared to the patientâs needs, since not all patients can be treated on a day-surgery basis. It is necessary to have a system in place for selecting patients carefully, considering surgical, medical (comorbidity) and social criteria. Objective: This study aims to identify the factors affecting implementation of day of surgery admission in hospital. Subjects and Methods: A descriptive cross-sectional design was used to achieve the aim of the study. The population included all the healthcare workers who involved in day of surgery admission process including surgeons, anesthetists, nurses, and administrative staffs in King Abdullah Medical City (KAMC). The researcher made a questionnaire for data collection which included five variables that affect the implementation of day of surgery admission procedures. Data was collected from the participants by using online survey questionnaires. Results: The result shows that all the factors have high mean score which indicate the participants positively agree the statements and when proving the hypothesis, the result appear that there's a solid relationship exist between consider factors and implementation of day of surgery admission. Finally, it was found that some dependent variables have positive correlation with others. Conclusion and Recommendations: it was concluded that the proper implementation of day of surgery admission with the organizational management support can contribute to reduce the waiting time of the patient, cancelation of procedures and all healthcare team will be satisfied. This study recommends the health care leaders to develop a strategic plan to implement day of surgery admission process However, further studies are needed to conduct by including patientâs opinions and as multicenter comparative study to find the effectiveness of day of surgery admission process.
Fingertip is the most important part of the finger. It has been described by Moberg as an organ of sensibility or the third eye. Injuries of the fingertips are very frequent as a result of industrial and domestic accidents which can result in permanent disability. We provide our experience about the indications, surgical technique and outcome of subcutaneous pulp flap in management of fingertip.
Inflammatory myofibroblastic tumor (IMT) is a rare tumor; characterized by a proliferation of myofibroblasts associated with inflammatory reaction cells and which can be observed at the various anatomical sites. The pancreas represents a very rare localization of this tumor. Surgery is the standard treatment, but for inoperable tumors; there is no consensus. We report a case of an inextirpable pancreatic IMT in a 46-years-old woman and we also carry out a literature review.
Introduction: Acute appendicitis is one of the most frequently encountered surgical emergencies, and over the years the surgical approach to which has undergone many changes. For decades, an open appendectomy was performed, until the 1990s when a laparoscopic approach gained popularity. Methods: A retrospective study was conducted to assess outcomes of 63 patients who underwent a laparoscopic appendectomy using a 3-port incision, where harmonic scalpel was utilized for the division of the appendiceal stump and mesoappendix. Results: None of our participants experienced any complications, 85.7% of appendixes were acutely inflamed at operation, the mean operative time was 31.4 minutes. Conclusions: Harmonic scalpel used for laparoscopic appendectomy is both safe and effective, and decreases morbidity compared to open appendectomies.
We report a case of a 43-year-old male who had a right partial nephrectomy for renal trauma. He was asymptomatic for 28 years before presenting with intermittent right flank pain. Imaging showed a tumor-like mass of the right adrenal gland. The anatomopathological of the resected specimen confirmed the diagnosis of textiloma.
Adrenal ganglioneuroma (AGN) is an extremely rare and benign tumor that originates from the neural crest tissue of the sympathetic nervous system. The majority of cases are detected incidentally. It presents a challenging preoperative diagnostic differential with other solid adrenal tumors. However, the assessment and management of AGNs are similar to other adrenal tumors. We present a case of a 40-year-old female referred to our institution for a right solid adrenal mass that was detected incidentally on an abdominal CT scan (4×5×5cm). The patient underwent laparoscopic surgical excision of the tumor. The histopathology examination showed areas of spindle cells and scattered mature ganglionic cells compatible with AGN.
Background: Cases of large intra-abdominal cyst in fetus are rare and determination of its origin is challenging. A multidisciplinary approach is recommended. Case Presentation: A large intra-abdominal cystic mass was found in a 28 weeks fetus during routine ante-natal scan. The baby was born via a scheduled cesarean section and initial physical examination revealed a distended abdomen. Ultrasonography of abdomen showed a large cystic mass in which the origin was undetermined. Hence, contrast enhanced computed tomography abdomen was performed, revealed grossly dilated pelvicalyceal system due to congenital ureteropelvic junction (UPJ) obstruction. The baby underwent right open dismembered pyeloplasty at days 27 of life. Post-operative period was uneventful and serial renal function test showed no renal impairment. Baby was discharged home after 40 days of operation. Conclusion: UPJ obstruction can present antenatally as a large cystic mass and multidisciplinary team involvement should be considered to determine the pre-natal and post-natal management. These include an appropriate delivery plan including method and place of delivery.
AIM: To provide a brief review of literature on intussusception due to inflammatory fibroid polyp (IFP). METHODS: A case report on inflammatory fibroid polyp presenting as ileo-colic intussusception made us review the literature on IFPs presenting as Intussusception, published in PubMed in English language. A comprehensive search of all case reports was done using keywords: intussusception due to IFP, intussusception and IFP, intussusception, IFP. The search covered all case reports from 2000 to 2020. RESULTS: 53 case reports with a total of 55 cases were analysed in this article, the range of age with such a presentation was from minimum10 years to maximum 79 yrs age, with median age of presentation 48years. 22 cases were males and 32 females, with one case gender not specified. Most common site of IFP presenting as intussusception was ileum (43cases), leading to ileo-colic intussusceptions, there were 11 case reports of jejunal intussusceptions also.
Diverticular disease is a growing problem in Western countries, with proportional impact on society and health spending. Its characteristic of being age-related together with the growing aging of the population will make diverticular disease as a problem increasing in the coming years. Natural history of the disease predicts that about 80 - 85% of patients with colonic diverticulosis will remain asymptomatic, while about 10 - 15% of population with colonic diverticulosis will develop symptoms, up to about 5% who will suffer from acute diverticulitis with its complications. In spite of a large scientific production, some aspects concerning diverticulitis still lack of high evidence and different topics about the role of surgery in both uncomplicated and complicated diverticulitis have long been under debate. Starting from history, through the natural evolution of the disease, we have reviewed the current trends regarding a surgical interest in acute diverticulitis.
Objectives: to determine the outcome of ventral hernia repair during abdominoplasty and mesh-abdominoplasty regarding cosmesis, recurrence and post-operative complications. Subjects and Methods: The present retrospective study included 78 multiparous women with ventral hernia and abdominal wall deformity. Age ranged between 28 and 59 years with a mean of 41.37±11.18 years. Half of the patients suffered from episodes of colicky abdominal pain and 34 (43.6%) had chronic low back pain. Forty patients (with defect 3cm) underwent mesh-abdominoplasty (Group 2), both after primary suture hernia repair and midline fascial plication. The follow-up period ranged from 22 months to 11 years with a mean of 62.5 months. Results: Both groups were comparable regarding their demographic and clinical parameters. Patients with abdominoplasty had significantly (p=0.0193) more para-umbilical hernias (PUHs) than those with mesh-abdominoplasty (80% vs 55.3%, respectively), but had less incisional or recurrent PUHs. All repaired hernias did not recur except for one patient in each group. No mortality or major complications were encountered. Wound complications occurred in 7 patients (17.5%) in Group 1 vs 10 (26.3%) in Group 2 (p=0.346). Recurrence of abdominal wall deformity and the need for a second refashioning procedure were significantly higher among patients who underwent abdominoplasty alone (p=0.011 and p=0.0139, respectively). Conclusions: (1) During abdominoplasty, ventral hernia repair and midline plication can be performed in defects 3 cm, additional mesh reinforcement is indicated and (3) Prolene mesh-abdominoplasty for multiparous women with severe musculo-aponeurotic laxity and ventral hernia, yields lower recurrence of abdominal deformity and less refashioning procedures with minimal complications than abdominoplasty alone.
Background: Data is lacking regarding the optimal CT timing for diagnosing intra-abdominal post-operative complications. Our aim was to examine the accuracy of CT imaging performed in the early post-operative period (POD 1-5) compared to late post-operative period (POD 6-14), in the detection of post-operative complications. Methods: Post-operative CT scans performed in the first 14 days following abdominal surgery, between 2011 and 2013 were reviewed and divided into two groups: early CT scans performed at POD 1-5 and late CT scans performed at POD 6-14. Analysis included clinical and laboratory parameters, radiologic findings and assessment of post-operative course according to CT scan results. Results: 318 CT scans were performed. The rate of repeated CT scans was higher in the patients included in the early CT scan group compared to the late CT scan group (23.1% vs. 11.2%, p=0.013). There were more re-operations in the early CT group, with no statistical difference (12.8% vs. 7.9%, p=0.23), whereas drainage procedures were more frequent in the late CT group (22.1% vs. 9.0%, p=0.008). Early CT scans were less sensitive in detecting post-operative GI complications (56% vs. 73%, p=0.018). The accuracy to detect post-operative complications was similar between the groups (83% vs. 88%, p=0.42). Conclusion: CT scans performed in the early post-operative period are less sensitive and tend to necessitate repeated scans. The accuracy of abdominal CT examination in detecting post-operative GI complications was not found to be statistically different between the early and late CT scan groups.
