ABSTRACT
Complete tract excision for complex fistula-in-ano, where the sphincter, is divided is increasingly being followed by immediate sphincter repair. We concluded, by a prospective study conducted on 60 consecutive patients, that this procedure is feasible and safe, and polydioxanone and polyglactin 910 in repair result in a comparable outcome.
Subject(s)
Anal Canal , Rectal Fistula , Humans , Prospective Studies , Treatment Outcome , Anal Canal/surgery , Rectal Fistula/surgerySubject(s)
Hair Follicle , Vitiligo/pathology , Adult , Cells, Cultured , Female , Humans , Male , Vitiligo/therapy , Young AdultABSTRACT
PURPOSE: Synthetic non-absorbable meshes are routinely used in hernia surgery for clean cases but are avoided in the case of clean-contaminated or contaminated hernia or dirty cases to minimize the risk of infection. The present study was conducted to evaluate the outcome of polypropylene mesh in the settings of bowel resection performed for strangulated hernias of the abdominal wall. METHODS: This prospective observational study was conducted in the Department of Surgery of a teaching hospital in central India between 1st March 2015 and 31st Aug 2017. Adult patients > 18 years age, with abdominal wall hernias, presenting with strangulation, and requiring resection and anastomosis for gangrenous bowel were included in the study. Outcomes noted were wound infection, morbidity and mortality, need for the removal of the mesh, and recurrence of the hernia. RESULTS: 30 (22 men and 8 women) patients with strangulated hernias underwent emergency surgery with resection of gangrenous bowel and anastomosis. The 30 cases included 21 inguinal, seven incisional, one femoral and one umbilical hernia. 12 of the 30 cases having gross contamination of the operative wound due to perforated gangrenous bowel were classified as 'dirty'; while the remaining 18 cases with non-perforated gangrenous herniating bowel were classified as 'contaminated'. Wound infection occurred in 8/30 patients (26.67%); but these healed with antibiotics and dressing. Mesh removal was not required in any patient during entire study period. Two recurrences (6.7%; one inguinal and one incisional hernia) were observed. There was no mortality. CONCLUSION: The use of polypropylene mesh for contaminated and dirty strangulated hernias is effective and safe, with acceptable morbidity and good short-term results.
Subject(s)
Biocompatible Materials/administration & dosage , Hernia, Abdominal/surgery , Herniorrhaphy/adverse effects , Polypropylenes/administration & dosage , Surgical Mesh/adverse effects , Surgical Wound/classification , Adult , Aged , Aged, 80 and over , Biocompatible Materials/adverse effects , Female , Gangrene/complications , Gangrene/surgery , Hernia, Abdominal/complications , Herniorrhaphy/methods , Humans , Intestine, Small/pathology , Intestine, Small/surgery , Male , Middle Aged , Polypropylenes/adverse effects , Prosthesis Implantation/adverse effects , Prosthesis Implantation/methods , Surgical Wound Dehiscence/etiology , Surgical Wound Dehiscence/therapy , Surgical Wound Infection/etiology , Surgical Wound Infection/therapyABSTRACT
This article examines the effect of pressure on the steady-state kinetics and long-term deactivation of the enzyme catalase supported on porous alumina. The reaction studied is the decomposition of hydrogen peroxide. The results of studies carried out in a continuous stirred-tank reactor under isothermal conditions are presented and compared with results obtained for soluble catalase. For soluble catalase, it is found that in the range of pressures studied, the oxygen flow rate increases with increase in pressure up to a certain value and then decreases. Hydrogen peroxide concentration appears to have a strong influence on pressure effects. With immobilized catalase, the pressure effects are not as prominent. Fluorescent microscopy studies of the immobilized enzyme suggest that this is probably because of pore diffusional limitations.
