“Barbed suture has been adopted across all surgical specialties. One of the infrequent complications seen with the use of barbed suture is small bowel obstructions (SBOs). In this study, we perform a review of the literature and the Manufacturer and User Facility Device Experience Database (MAUDE) to characterize SBOs after the use of barbed sutures
in a variety of operative procedures.”
“Anastomotic leaks after colorectal surgery is associated with increased morbidity and
mortality. Understanding the impact of anastomotic leaks and their risk factors can
help the surgeon avoid any modifiable pitfalls. The diagnosis of an anastomotic leak can
be elusive but can be discerned by the patient’s global clinical assessment, adjunctive
laboratory data and radiological assessment. The use of inflammatory markers such as
C-Reactive Protein and Procalcitonin have recently gained traction as harbingers for a
leak. A CT scan and/or a water soluble contrast study can further elucidate the location
and severity of a leak. Further intervention is then individualized on the spectrum of
simple observation with resolution or surgical intervention.”
“Splenic injury is a major intraoperative complication of abdominal surgery and places patients at a higher risk of morbidity and mortality, of longer operating time, and of longer hospital stay. Splenic injuries may be managed nonoperatively or by splenorrhaphy, partial splenectomy, or complete splenectomy. Because splenectomy is reported to have higher mortality rates than splenorrhaphy, great effort is taken to preserve the spleen; however, excessive blood loss can mandate splenectomy.”
“The risk factors and incidence of anastomotic leak following colorectal surgery are well reported in the literature. However, the management of the multiple clinical scenarios that may be encountered has not been standardized.”
In this study, “management scenarios were divided into those for intraperitoneal anastomoses, extraperitoneal (low pelvic) anastomoses, and anastomoses with proximal diverting stomas. Management options were then based on the clinical presentation and radiographic findings and organized into three interconnected algorithms.”
“Acute mesenteric ischemia (AMI) accounts for approximately 1:1000 acute hospital admissions in the United States, and the incidence is on the rise likely due to an aging population as well as the prolonged survival of critically ill patients. AMI can be caused by a reduction in blood flow from arterial occlusion, venous occlusion, arterial vasospasm, or a low-flow state. Regardless of the etiology of the disease, rapid diagnosis and treatment of AMI is of critical importance”
“Anorectal infections in neutropenic leukemia patients are a significant and potentially life-threatening complication. The pathogenesis of this condition is not entirely understood and believed to be multifactorial, including mucosal injury as a result of cytotoxic drugs, profound neutropenia and impaired host defense. Establishing an early diagnosis is key and often made clinically on the basis of signs and symptoms, but also from imaging studies demonstrating perianal inflammation or fluid collection. The management of anorectal infections in neutropenic leukemia patients is not straightforward, as there are no well-conducted studies on this entity.”
“Diabetes continues to be a significant comorbidity that needs to be accounted for during surgical planning. Furthermore, undiagnosed diabetes or ‘pre-diabetes’ results in an underestimation of the true number of patients with diabetes having colorectal
surgery, with studies reporting that the true prevalence of diabetes in hospitalised patients has been understated by up to 40%. In the existing literature, poor glycemic control and hyperglycemia has been associated with impaired wound healing and increased susceptibility to infections,leading to an elevated risk of postoperative complications.”
Surgical Focus 