Painful Repair Research Articles

Effect of Humor Therapy on Chronic Pain: A Literature Review

Introduction: Chronic pain is an unpleasant sensory and emotional experience with actual or potential tissue damage, or is described as a damage lasting more than 3 months with heavy or moderate intensity. The patient's response to the pain he experienced was done in different ways such as shouting, grimacing, crying, etc. Repair of pain is likely to occur more quickly when psychological intervention is included in medical care because it requires alternative and complementary treatment to overcome the pain including prayer , humor, hypnosis, and group support. Growing evidence-based nursing practice shows progress in helping patients deal with the pain. One of the evidence-based nursing practices is humor therapy.
 Method: The literature search was done through searching the results of scientific publications 2010-2018 using several databases, such as Such as Google scholar, PubMed, DOAJ, and Cochran, with keyword "Humor Therapy and Chronic Pain.
 Result: Obtained 6 fulltext articles, were obtained with various methods used, such as quasi-experimental pre- and posttest control group design, randomized two-group review literature, concluded that humor therapy proved effective in reducing chronic pain in all ages.
 Conclusion: The humor therapy is effective in reducing chronic pain in patients of all ages, both children, adults and the elderly, besides humor therapy can also be used to increase endurance and quality of life in elderly who are cared for in nursing homes

Robotic-assisted ventral hernia repair with surgical mesh: how I do it and case series of early experience.

Laparoscopic ventral hernia repair provides several benefits over the open approach. Intraperitoneal surgical mesh placement without fascial defect closure is associated with increased seroma formation and other adverse hernia-site outcomes. Transfascial sutures and tacs for fascial closure and surgical mesh fixation are associated with greater post-operative pain. Robotic-assisted ventral hernia repair (rVHR) may afford benefits of the laparoscopic approach while facilitating a more robust and less painful repair. Consecutive patients managed by rVHR from May 2015 to August 2018 were identified from a prospectively maintained robotic database. Retrospective review of this data was performed. Fifty patients underwent rVHR during the study period. Median body mass index was 31 (interquartile range (IQR) 29-34). Forty-eight had previous abdominal surgery. Forty-seven hernias were midline and three were lateral. Regarding hernia width, 15 were <4 cm wide, 32 were 4-10 cm and three were >10 cm. Median total anaesthetic time, docking time and surgical console time were 214 min (IQR 182-252), 5 min (IQR 4-8) and 144 min (IQR 104-174), respectively. No major intra-operative complications occurred. No documented cases of adhesional complications or chronic post-operative pain have occurred. To date, two recurrences have occurred in our series. Median length of hospital stay was 3 days (IQR 2-4). We describe our rVHR technique and report on our series and early experience, showing that rVHR can be performed safely with good patient outcomes. We demonstrate a team approach to achieving a safe transition to new technology.

Patient priorities with traumatic lacerations

Clinical trials should use outcomes that are important to patients. We sought to determine the aspects of laceration management that are most important to patients. Aprospective observational survey was conducted at one suburban and one urban university ED during November to December 1998 that included ED patients and visitors with and without current or prior lacerations. Trained research assistants approached 747 people of which 724 (97%) completed a 25-item closed question survey that evaluated demographics, prior laceration repairs, and assessed the relative importance of least painful repair, ED length of stay, cosmetic outcome, functional recovery, practitioner compassion, avoidance of wound infection, total costs, and missed days of work or school using a five-item Likert scale (not important—extremely important). Additionally, the relative importance of these items was compared. Data were analyzed with descriptive statistics and 95% confidence intervals (CIs). Seven hundred twenty-four people participated; 383 (53%) had prior lacerations; 92 (14%) had lacerations at the time of the survey. The most important aspect of care for respondents were normal function (28%), avoiding infection (20%), cosmetic outcome (17%), and least painful repair (17%). Based on Likert scale data, most important aspects of care were: avoiding wound infection (mean [95% CI], 4.58 [4.52 to 4.64]), normal function (4.54 [4.48 to 4.6]), cosmetic outcome (3.78 [3.68 to 3.88]), and least painful repair (3.84 [3.76 to 3.92]). Cost, length of stay, missed work/school, and compassion were less important (range, 3.0 to 3.7). Patients with facial lacerations chose cosmetic outcome as the most important aspect of care while all others chose function. Patients prioritize the medical outcomes of laceration repair (function, avoiding infection, cosmesis, pain) more than cost, compassion, ED length of stay and inconvenience (missed work/school). Cosmetic outcome is particularly important to patients with facial lacerations. This information should be useful when designing outcome studies of laceration management. (Am J Emerg Med 2000;18:683-686.