Does Immediate Colon Surgery Within Two Hours Predict a Negative Postoperative Outcome? A Prospective Cohort Study.

BACKGROUND: The aim of this study was to evaluate whether immediate surgery within 2 hours is a prognostic factor for adverse postoperative outcomes. METHODS: This was a prospective observational study that included all consecutive patients who underwent emergency and elective colon resection at a tertiary-level hospital for malignant or benign conditions over a 13-month period. Postoperative outcomes included morbidity, mortality, reoperation, readmission and length of stay. The statistical analysis included both univariate and multivariate tests, with statistical significance set at p<0.05. RESULTS: Over a 13-month period, 300 colon resections were performed. Twenty-five cases (8.3%) underwent emergency operations within 2 hours of admission. Immediate surgery was associated with worse postoperative outcomes including higher mortality and reoperation rates: 40% versus 5.8% (p <0.0001, OR: 10.79, 95% CI: 4.18-27.79) and 20% versus 6.9% (p=0.02, OR: 3.36, 95% CI: 1.19-9.97), respectively. Postoperative outcomes were also worse in operations for malignant tumors (OR: 6.97, 95% CI: 2.82-17.60, p< 0.0001). CONCLUSION: Immediate colon surgery within 2 hours is a negative predictor for morbidity and mortality.

Polylactic Acid-Lemongrass Essential Oil Nanocapsules with Antimicrobial Properties.

Polylactic acid was combined with lemongrass essential oil (EO) to produce functional nanocapsules (NCs). The obtained polylactic acid nanoparticles showed antimicrobial activity both with and without the presence of lemongrass oil; however, the presence of EO improved the activity of the NCs. The presence of lemongrass assisted the formation of well-separated NCs and also provided enhanced antimicrobial properties, since lemongrass is known for its antimicrobial character. Fluorescence microscopy was used to optically observe the nanoparticles and NCs and revealed the attachment of lemongrass oil with the polylactic acid NCs. Dynamic light scattering was used to determine their size. UV absorption was used to determine the exact amount of lemongrass oil found in the polylactic acid-lemongrass oil NCs, which was important for understanding the minimum inhibitory concentration for the antimicrobial experiments. A series of clinically important microbial species were used in the study and the obtained NCs proved to have very good antimicrobial properties against all tested strains. Such NCs can be used for the design of ecological strategies, based on natural alternatives, which may be efficient against severe infections, including those that involve resistant pathogens and biofilms or those with difficult to reach localization.