Postoperative Recovery Of Patients Research Articles

Correlation linking illness perception, negative emotions, and the post-operative recovery effect in patients with perianal disease

BACKGROUND Improvements in the standard of living have led to increased attention to perianal disease. Although surgical treatments are effective, the outcomes of post-operative recovery (POR) are influenced by various factors, including individual differences among patients, the characteristics of the disease itself, and the psychological state of the patient. Understanding these factors can help healthcare providers develop more personalized and effective post-operative care plans for patients with perianal disease. AIM To investigate the effect of illness perception (IP) and negative emotions on POR outcomes in patients with perianal disease. METHODS A total of 146 patients with perianal disease admitted to the First People's Hospital of Changde City from March to December 2023 were recruited. We employed a general information questionnaire, the Brief Illness Perception Questionnaire (B-IPQ), and the Hospital Anxiety and Depression Scale (HADS). We used the 15-item Quality of Recovery Score (QoR-15) to measure patients’ recovery effects. Finally, we conducted Pearson’s correlation analysis to examine the relationship between pre-operative IP and anxiety and depression levels with POR quality. RESULTS Fifty-three (36.3%) had poor knowledge of their disease. Thirty (20.5%) were suspected of having anxiety and 99 (67.8%) exhibited symptoms. Forty (27.4%) were suspected of having depression and 102 (69.9%) displayed symptoms. The B-IPQ, HADS-A, HADS-D, and QoR-15 scores were 46.82 ± 9.97, 12.99 ± 3.60, 12.58 ± 3.36, and 96.77 ± 9.85, respectively. There was a negative correlation between pre-operative IP, anxiety, and depression with POR quality. The influence of age and disease course on post-operative rehabilitation effect are both negative. The impact of B-IPQ, HADS-A, and HADS-D on POR was negative. Collectively, these variables accounted for 72.6% of the variance in POR. CONCLUSION The quality of POR in patients with perianal disease is medium and is related to age, disease course, IP, anxiety, and depression.

Clinical outcomes of arthroscopic suture fixation combined with loop plate vs. posterior approach open reduction and cannulated screw fixation for treating tibial avulsion fractures of the posterior cruciate ligament: a retrospective study

Background Comparison of the efficacy of arthroscopic suture fixation combined with loop plate vs. the posterior approach involving open reduction and intramedullary nail fixation in treating posterior cruciate ligament tibial avulsion fractures (PCLTAFs). Methods A retrospective analysis was conducted on the clinical data of patients diagnosed with PCLTAF who were admitted to Northern Jiangsu People’s Hospital between June 2019 and March 2022. Based on distinct surgical procedures, the patients were categorized into two groups: arthroscopic group (33 cases), involving a single bone tunnel, high-strength suture, loop plate, and anchor screw fixed under arthroscopy, and open reduction and internal fixation (ORIF) group (13 cases), involving a modified posterior medial approach and fixation using 1–2 cannulated screws. Key parameters, including surgical duration, postoperative fracture alignment, fracture-healing duration, range of motion changes, postoperative Lysholm scores, and VAS scores were documented and compared between the two groups. Results The study cohort comprised 46 patients, with 28 males and 18 females, and the median age was 29 years old (range: 15–69). There were no significant differences in the baseline characteristics, including knee Lysholm scores, between the two groups. The arthroscopic group exhibited significant improvement in all eight Lysholm score indicators (all P < 0.001). The total Lysholm score also exhibited significant improvement before and after surgery in both groups (P < 0.001). Following surgery, the arthroscopic group demonstrated improvements in all indicators, but had a slightly longer operating time compared to the ORIF group. No significant differences were observed in the Lysholm scores for the knee joint between the two patient groups before and after surgery (P > 0.05). Conclusions Arthroscopic suture fixation in conjunction with looped plate binding can significantly improve knee function and clinical effect for patients in the treatment of PCLTAF, promotingearly postoperative functional recovery of patients.

Undergoing Orthopaedic Day Surgery: What Factors Are Associated With patients' Feeling of Safety and Their Recovery?

The study aimed to examine factors associated with the perceived feeling of safety and postoperative recovery in patients who have undergone orthopaedic day surgery under regional anaesthesia. The design was quantitative, descriptive, and cross-sectional. The study participants comprised a consecutive sample (n = 209) of patients who underwent orthopaedic day surgery under regional anaesthesia. A questionnaire was sent to the home addresses of the study population approximately 3 weeks postoperatively. The questionnaire included the Feeling Safe During Surgery Scale (FSS), the Swedish version of the post-discharge surgical recovery scale (S-PSR), and questions concerning background variables. Multivariate regression models were used to examine the association of different variables with both feeling safe and postoperative recovery. The only factor associated with the feeling of safety was preoperative anxiety; higher levels of preoperative anxiety were associated with lower levels of perceived safety during surgery. The factors associated with postoperative recovery were the recovery process itself and the patient's feeling of safety. Higher levels of postoperative anxiety were associated with a lower level of postoperative recovery. Higher levels of perceived safety during surgery were associated with higher postoperative recovery. The perceived feeling of safety in the perioperative period could not be explained by factors such as age, gender, or level of education. Based on the results of this study, postoperative recovery was associated with the perceived feeling of safety in the perioperative period. Anxiety in the perioperative period was associated with patients' perceived feeling of safety and their postoperative recovery. Thus, this study's results emphasise the importance of ensuring that people undergoing surgery feel safe to promote their recovery. Based on previous research, the nurse-patient relationship seems to be an important part of making patients feel safe, which ultimately affects their recovery. This study examines the association between perceived feeling of safety in the perioperative period and patients' postoperative recovery after undergoing orthopaedic day surgery under regional anaesthesia. Previous research has shown that the nurse-patient relationship and patients' possibilities to participate in their care are important for them to feel safe. This study further emphasises the importance of fostering relationships in the perioperative period and making patients an active part in decision-making, as it may positively impact their recovery. Creating a feeling of safety for the patient should be prioritised, as it benefits their perioperative experience and postoperative recovery. This research is reported in accordance with the STROBE guidelines. No patient or public contribution.

Application of detailed nursing management intervention in neurosurgical nursing.

In the contemporary healthcare environment, optimizing patient care strategies is of importance, particularly in neurosurgical environments. While traditional nursing methods have the foundation of patient care, there exists a growing recognition of the potential benefits of comprehensive nurse management. Despite this acknowledgment, there remains a gap in understanding the comparative effectiveness of comprehensive nurse management versus traditional approaches in reducing postoperative psychological stress, enhancing patient satisfaction, and promoting adherence in neurosurgical patients. This study compares the efficacy of comprehensive nurse management against traditional methods in facilitating the postoperative recovery of neurosurgical patients. Taking the traditional nursing management and detailed nursing management of neurosurgical patients in a municipal neurosurgical hospital from March 2021 to March 2022 as an example, the neurosurgery was divided into 50 patients in the detailed nursing management group and 50 patients in the traditional nursing management group. In the clear nursing management group, there were 50 patients, 20 male patients, with an average age of 58.7 ± 3.8 years, and 30 female patients, with an average age of 60.4 ± 4.3 years; In the traditional nursing management group, there were 50 patients, 26 male patients, with an average age of 59.7 ± 3.7 years, and 24 female patients, with an average age of 59.4 ± 3.9 years; Among the 100 patients, there were 60 cases of cerebral infarction, 25 cases of intracerebral hemorrhage and 15 cases of other neurosurgical diseases. Hundred neurosurgical patients were divided into two groups: comprehensive nursing management group and traditional nursing management group. The results showed that the comprehensive treatment effect of patients with detailed nursing management was better than that of the routine nursing group. At the same time, the complications were reduced, and the patient's satisfaction was higher. Through retrospective analysis and investigation of patients, this paper discusses the clinical application of a detailed nursing management model in neurosurgery, which can reduce the probability of infection and other complications and improve the quality of life and treatment effect of patients.

The Effect of Ultrasound-Guided Erector Spinae Plane Block on Postoperative Opioid Consumption and Respiratory Recovery in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study.

The aim of this prospective, randomized, controlled study was to evaluate the effect of ultrasound (US)-guided bilateral erector spinae plane (ESP) block on postoperative opioid consumption and respiratory recovery in patients with obesity undergoing laparoscopic sleeve gastrectomy (LSG). The study was conducted on 40 patients scheduled for LSG. The patients were randomly allocated into either the ESP block group or the control group. The US-guided bilateral ESP block was performed preoperatively. The control group received no intervention. Postoperative median [IQR] tramadol consumption was significantly lower in the ESP block group [150.0 [100-200] mg vs 450.0 [400-500] mg, p < 0.0001]. Postoperative spirometric variables were significantly impaired in both groups, compared with preoperative variables (p < 0.0001). Intraoperative median [IQR] fentanyl consumption was 200.0 [200-200] µg in the ESP block group, and 350.0 [300-400] µg in the control group (p < 0.0001). Postoperative mean pain scores at rest and during movement were significantly lower in the ESP block group, at all time points (p < 0.05). In terms of mean arterial PH, Horowitz ratio, and PaCO2, there was no statistically significant difference between the groups (p > 0.05). None of the patients experienced postoperative respiratory adverse events and/or block-related complications. US-guided bilateral ESP block significantly reduced both intraoperative and postoperative analgesic consumptions and provided effective postoperative pain control for patients with obesity undergoing bariatric surgery. Following bariatric surgery, all patients' postoperative pulmonary functions deteriorated. The effect of US-guided bilateral ESP block on postoperative respiratory recovery could not be clearly demonstrated. Randomized controlled studies with a larger patient population are necessary.

Comparison of the effects of perioperative intravenous infusions of esmolol and lidocaine on the quality of postoperative recovery in patients undergoing functional endoscopic sinus surgery: a randomized, double-blind, noninferiority study.

Perioperative intravenous lidocaine infusion can improve the quality of recovery (QoR) in patients undergoing functional endoscopic sinus surgery (FESS), but the effect of esmolol on recovery has been rarely studied. The aim of this study to compare the effects of esmolol and lidocaine on the QoR in patients with FESS. A total of 60 patients were randomly divided into Group E: intravenous esmolol (0.5mg/kg for 1min, followed by 3.0mg/kg/h); Group L: intravenous lidocaine (2.0mg/ kg for 10min, followed by 2mg/kg/h). The quality of recovery-15 (QoR-15) score was compared. Other parameters compared were the numeric rating pain scale (NRS), haemodynamic data, Surgical fieldconditions, intraoperative drug dosages, number of cases of remedial analgesia, time toawakening and incidence of postoperative sore throat (POST) as well aspostoperative nausea and vomiting (PONV). The mean difference in the QoR-15 score between Group E and Group L on postoperative day 1 (POD1) was - 1.37 (95% CI - 2.75 to 0.01; P < 0.001for noninferiority), indicating the noninferiority of esmolol. Haemodynamic changes and intraoperative nitroglycerine dosages were significantly lower in Group E than in Group L (P < 0.05). The scores of surgical field quality (SSFQ) was higher in Group E than in Group L (P < 0.05). Intravenous infusion of esmolol is not inferior to lidocaine in the quality of postoperative recovery in patients with FESS, and is more advantageous in terms of the quality of the surgical field, attenuation of intraoperative haemodynamic fluctuations, and postoperative awakening.

No Difference in Postoperative Recovery Outcomes Between Opioid-Free and Opioid-Sparing Anesthesia Under Multimodal Analgesic Protocol for Video-Assisted Thoracoscopic Surgery: A Propensity Score Matching Cohort Study.

Background: With growing concerns about opioid-related risks, efforts to reduce opioid use throughout the perioperative period have increased. This study aimed to compare postoperative recovery outcomes between opioid-free anesthesia (OFA) and opioid-sparing anesthesia (OSA) under a multimodal analgesic protocol in video-assisted thoracoscopic surgery (VATS). Methods: A retrospective cohort study was conducted on 196 patients undergoing VATS from August 2019 to December 2021. Patients received either dexmedetomidine-based OFA or remifentanil-based OSA. Postoperative recovery was assessed using the Quality of Recovery-15 (QoR-15) score, opioid consumption, and pain intensity. Additionally, opioid-related complications and intraoperative hemodynamic changes were evaluated. Results: Both groups showed similar QoR-15 scores 24 h postoperatively (124.2 ± 7.0 vs. 123.0 ± 6.9, p = 0.227). Opioid consumption and pain intensity were comparable, and the incidence of opioid-related adverse events did not significantly differ between the groups. Intraoperative hypotension and bradycardia were more frequent in the OFA group, but the differences were not statistically significant. Conclusions: The study concluded that both OFA and OSA, when used under a multimodal analgesic protocol, provided effective postoperative recovery in patients undergoing VATS with no significant differences in outcomes.

Evaluating Postoperative Pain and Recovery in Patients Undergoing Laparoscopic Surgery for abdominal pain

Evaluating Postoperative Pain and Recovery in Patients Undergoing Laparoscopic Surgery for abdominal pain

Effectiveness of refined nursing intervention on postoperative recovery and respiratory function in lung cancer patients after thoracic surgery.

To evaluate the effectiveness of refined nursing intervention versus routine nursing care in improving respiratory function and facilitating their recovery in lung cancer patients after thoracic surgery. Total 75 primary lung cancer patients (average age: 55.3 ± 10.8 years) who underwent thoracic surgery at Tangshan People's Hospital from February 2024 to July 2024 were included in the study. According to the different postoperative nursing intervention, patients were randomized into control group (CG) and observational group (OG) for evaluating the effects of refined nursing intervention on pain relief, postoperative recovery and respiratory function. Tidal volume, vital capacity, forced expiratory volume in 1 second, peak expiratory flow, and maximal voluntary ventilation were used to evaluate pulmonary function. The Medical Outcomes Study 36-Item Short-Form Health Survey and Nursing Intensive-Care Satisfaction Scale were administered at the minimum of 30 days of nursing interventions after thoracic surgery to assess quality of life and satisfaction with nursing care respectively. Bivariate correlation analysis and chi-square test (χ2) were used to analyze significant changes by using SPSS (version 27.0). About 61% (n = 46) of the patients were female. Routine nursing care was conducted in both CG and OG patients, while in OG simultaneously received refined nursing care. After a period of nursing intervention, recovery rate of heart and pulmonary was significantly higher than CG (92.31% vs 72.22%, P = .022) with a lower incidence of postoperative complications (12.82% vs 30.56%, P = .049). Pulmonary function test results revealed a significant improvement in OG patients' tidal volume (0.43 ± 0.06 vs 0.39 ± 0.07, P = .014), vital capacity (3.53 ± 0.30 vs 3.34 ± 0.32, P = .020), forced expiratory volume in 1 second (4.67 ± 0.67 vs 4.23 ± 0.58, P = .003), peak expiratory flow (4.76 ± 0.51 vs 4.36 ± 0.51, P = .001) and maximal voluntary ventilation (58.22 ± 7.86 vs 53.70 ± 6.89, P = .010) compared to CG. Postoperative moderate-to-worst pain duration in OG was significantly shortened (4.36 ± 1.56 vs 5.81 ± 1.94, P < .001), while health status value was higher (60.87 ± 5.89 vs 56.53 ± 6.22, P = .003). Moreover, OG expressed higher satisfaction with nursing care compared to CG (P = .002). Patients experienced reduced respiratory function after thoracic surgery. Refined nursing intervention might facilitate patients' postoperative recovery and improve their respiratory function and general well-being, which would be beneficial for achieving patients' satisfaction and promoting positive interaction between patients and multidisciplinary team members.

The active advantage: Objective measurement of preoperative activity is associated with postoperative recovery and outcomes in gynecologic oncology patients

The active advantage: Objective measurement of preoperative activity is associated with postoperative recovery and outcomes in gynecologic oncology patients

The impact of early cranioplasty on neurological function, stress response, and cognitive function in traumatic brain injury.

To analyze the efficacy of early cranioplasty in patients with traumatic brain injury and its impact on neurological function, stress response, and cognitive function. A total of 90 patients with traumatic brain injury admitted to the hospital from January 2021 to March 2024 were included in the study. The patients were divided into an observation group (45 cases) and a control group (45 cases) based on the timing of their cranioplasty. The control group underwent cranioplasty 3 to 6 months post-trauma, while the observation group received cranioplasty within 3 months post-trauma. Neurological function was assessed using the National Institutes of Health Stroke Scale. Cognitive function was evaluated using the Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination. Blood samples were collected to measure and compare serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha between the 2 groups. The observation group demonstrated a higher rate of excellent recovery compared to the control group (95.56% vs 80.00%), with significantly lower National Institutes of Health Stroke Scale scores ([11.18 ± 2.35] vs [14.74 ± 3.61], P < .05). Posttreatment scores for Functional Independence Measure, Mini-Mental State Examination, and Neurobehavioral Cognitive Status Examination were significantly higher in the observation group compared to the control group ([59.26 ± 6.12] vs [47.86 ± 5.27], [25.02 ± 4.61] vs [22.74 ± 5.13], [103.52 ± 10.63] vs [88.76 ± 7.39], P < .05). Serum levels of interleukin-6, cortisol, and tumor necrosis factor-alpha were significantly lower in the observation group ([22.76 ± 4.15] ng/mL vs [25.38 ± 5.27] ng/mL, [66.29 ± 4.91] nmol/L vs [78.24 ± 6.08] nmol/L, [3.36 ± 1.02] ng/mL vs [4.91 ± 0.98] ng/mL, P < .05). The total incidence of postoperative complications was significantly lower in the observation group (8.70% vs 26.09%, P < .05). Early cranioplasty is beneficial for the postoperative recovery of patients with traumatic brain injury. It improves neurological function, enhances cognitive function, and reduces stress response, while also significantly lowering the incidence of postoperative complications.

Nonpharmacological interventions for managing postoperative pain and anxiety in children: A randomized controlled trial.

Hospitalizations and surgical procedures are unpleasant for both children and their parents. Therefore, postoperative pain assessments and management are less commonly performed in younger children than in adults. To evaluate the effects of nonpharmacological interventions on postoperative pain and anxiety in children. In this randomized controlled trial, 160 children were randomly allocated to experimental (n=80) and control (n=80) groups. The children in the experimental group received age-appropriate distraction interventions for 3 postoperative days along with usual care. Children in the control group received standard care only. Each patient's pain was assessed using the EVENDOL pain scale, while their anxiety was measured using the modified Yale Preoperative Anxiety Scale. The data were analyzed using SPSS 23.0. Descriptive statistics (frequency, percentage, mean, and standard deviation) and repeated-measures analysis of variance were used to analyze the data. The children in the experimental group showed significantly decreased pain, anxiety, and physiological parameters (heart rate, respiratory rate, and oxygen saturation) compared to those in the control group. Significant intergroup differences were noted in the mean and standard deviation values of the pain, anxiety, and physiological parameters. The distraction interventions provided by nurses reduced the pain and anxiety levels and improved the postoperative recovery of pediatric surgical patients.

The Effect of the Application of Adductor and Infiltration of Local Anesthetic Between the Popliteal Artery and Capsule of the Knee (IPACK) Block to Patients on Postoperative Recovery and Sleep Quality Following Total Knee Arthroplasty: a Randomized, Controlled Study

Aim: The adductor canal block (ACB) and IPACK (Infiltration of local anesthetic between the popliteal artery and capsule of the knee) block are motor protective blocks that provide effective analgesia and allow early ambulation. The aim of this study was to investigate the effect on postoperative recovery and sleep quality of patients applied with ACB and IPACK for total knee arthroplasty (TKA). Material and Method: This prospective, double-blinded, randomized, controlled study included 80 patients who underwent unilateral TKA under spinal anesthesia. The patients were separated as those applied with ACB+IPACK (Group ACB+IPACK, n=40) and a control group (Group C, n=40). The primary outcome was the postoperative first-day quality of recovery scale (QoR-15). Secondary outcomes were postoperative first and second-day Timed-Up-and-Go (TUG) test and range of motion (ROM), the total amount of rescue opioid drugs required, pain scales at different time points in the first 48 hours postoperatively, sleep evaluation on the postoperative and 6 following nights, and evaluation of sleep quality for 1 month using the Pittsburgh Sleep Quality Index (PSQI). Results: The QoR on postoperative days 1 and 7 were better in the ACB+ IPACK group than in the control group (p= 0.001, p= 0.002, respectively). On postoperative days 1 and 2, the TUG (p= 0.035, p= 0.019, respectively) and ROM (p=0.003, p=0.000) values were higher in the ACB+ IPCAK group. Postoperative opioid consumption was lower in the ACB+IPACK group (p= 0.012). The PSQI values at 1 month postoperatively were similar in both groups (p =0.095). Conclusion: The study results demonstrated that ACB+IPACK applied with ultrasound for TKA postoperative analgesia provided effective analgesia, higher QoR and physical performance, and reduced postoperative opioid consumption. However, there was no effect on postoperative sleep quality.

Relationship between histological findings of vastus lateralis muscle and function after total hip arthroplasty in patients with hip fracture: a prospective cohort study.

We aimed to examine the histological characteristics of vastus lateralis muscles in patients undergoing total hip arthroplasty (THA) following femoral neck fractures and to explore the correlation between muscle fiber types and postoperative functional recovery. 34 patients undergoing THA for femoral neck fractures were included. A biopsy of the vastus lateralis muscle was performed during surgery, followed by immunohistochemical staining. Subsequently, image analysis was conducted to measure the average area of muscle fiber types and the number of type I and II muscle fibers, and the ratio of the area and the number of type II muscle fibers. Functional recovery was assessed 2 weeks post-surgery using the Short Physical Performance Battery (SPPB). A significant positive correlation was observed between type II muscle fibers and SPPB scores. The ratio of type II muscle fiber area and number strongly correlated with the SPPB scores, indicating a robust static association. The average area of type II fibers showed a strong correlation (r = 0.63, P < 0.001), as did the number of type II fibers (r = 0.53, P = 0.001). Moreover, the ratio of type II muscle fiber area and number significantly correlated with SPPB scores (area: r = 0.77, P < 0.001; number: r = 0.51, P = 0.002), indicating that larger and more numerous type II fibers are associated with better physical performance. The reduction of type II muscle fibers was strongly correlated with a low SPPB postoperative functional recovery in patients who underwent THA following femoral neck fractures.

Short-term postoperative recovery for patients after Thulium Laser Vapoenucleation of Prostate: evaluation of the impact of lower urinary tract symptoms on quality of life.

We evaluated short-term postoperative recovery in patients with benign prostatic hyperplasia (BPH), especially focusing on symptoms reduction and life quality enhancement. We prospectively enrolled 160 BPH patients who underwent surgery and were followed up regularly for 12 weeks, collecting the International Prostate Symptom Score (IPSS), Quality of Life (QoL), and Qmax. Regression analysis and mixed effect models were used to evaluate the tendency of symptoms on recovery from the perspective of quality of life. At 12 weeks, all patients recovered well with conspicuous change in IPSS, QoL and Qmax, that were 4.80 ± 4.59, 1.34 ± 1.14,20.02 ± 8.61 mL/s respectively. Voiding symptoms were significantly reduced by 79.4% at 2 weeks, whereas storage symptoms recovered slowly until 12 weeks with residual lower urinary tract symptoms (LUTS), predominantly urinary frequency and nocturia. Improvements in incomplete emptying urination and urinary frequency were significantly associated with QoL. With regards to the comprehensive full-cycle treatment of LUTS patients, in addition to the objective results, more attention should also be focused on the change in following symptoms, that is, incomplete emptying urination, urine frequency and urination difficulty, which play key roles in the enhancement of patients' quality of life.

The Effect of Carbodiimide Crosslinkers on Gelatin Hydrogel as a Potential Biomaterial for Gingival Tissue Regeneration

Connective tissue grafts for gingival recession treatment present significant challenges as they require an additional surgical site, leading to increased morbidity, extended operative times, and a more painful postoperative recovery for patients. Gelatin contains the arginine–glycine–aspartic acid (RGD) sequence, which supports cell adhesion and interactions. The development of gelatin hydrogels holds significant promise due to their biocompatibility, ease of customization, and structural resemblance to the extracellular matrix, making them a potential candidate for gingival regeneration. This study aimed to assess the physical and biological properties of crosslinked gelatin hydrogels using EDC/NHS with two crosslinker concentrations (GelCL12 and GelCL24) and compare these to non-crosslinked gelatin. Both groups underwent morphological, rheological, and chemical analysis. Biological assessments were conducted to evaluate human gingival fibroblast (HGF) proliferation, migration, and COL1 expression in response to the scaffolds. The crosslinked gelatin group exhibited greater interconnectivity and better physical characteristics without displaying cytotoxic effects on the cells. FTIR analysis revealed no significant chemical differences between the groups. Notably, the GelCL12 group significantly enhanced HGF migration and upregulated COL1 expression. Overall, GelCL12 met the required physical characteristics and biocompatibility, making it a promising scaffold for future gingival tissue regeneration applications.

The Value of Refined Nursing Management for Surgical Efficiency, Postoperative Recovery, and Stress Response in Laparoscopic General Surgery.

The study aimed to explore the impact of refined nursing management in the operating room on surgical efficiency, postoperative recovery, and stress responses in patients undergoing laparoscopic general surgery. A retrospective analysis was conducted on 100 patients who underwent laparoscopic surgery at Zhongnan Hospital of Wuhan University between March 2023 and March 2024. The control group comprised 48 cases receiving conventional operating room nursing, while the observation group comprised 52 cases receiving refined nursing management in the operating room in addition to the conventional care. Comparisons were conducted between the two groups regarding surgical efficiency, postoperative recovery, postoperative stress indicators, psychological status before and after nursing, overall treatment comfort, perioperative complications, and nursing satisfaction. The observation group showed statistically significant improvements in surgical efficiency, postoperative recovery, and stress indicators compared to the control group. After the intervention, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores of both groups significantly decreased compared to pre-nursing levels (p < 0.05), while such decrease was notably higher in the observation group (p < 0.05). Patients in the observation group reported significantly higher post-nursing comfort levels (p < 0.05) and exhibited significantly fewer perioperative complications (p < 0.05) compared to the control group. Furthermore, the nurses indicated significantly higher satisfaction with patient care in the observation group (p < 0.05). Implementing refined nursing in the operating room for laparoscopic general surgery can facilitate the recovery of gastrointestinal function, reduce postoperative recovery time, prevent complications, improve patients' psychological state, and enhance their quality of life.

Changes in postoperative depression and anxiety and their relationship with recovery from femoral head necrosis: A longitudinal study.

Femoral head necrosis (FHN) can significantly affect patients' psychological well-being and functional outcomes. However, the long-term relationship between postoperative depression, anxiety, and functional recovery in patients with FHN remains unclear. To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years. Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study. Depression and anxiety status were assessed using the hospital anxiety and depression scale (HADS) at baseline, 6 months, 1, 2, and 3 years postoperatively. Functional recovery was evaluated using the Harris hip score (HHS). The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA; the relationship between depression/anxiety status and functional recovery was examined using Pearson's correlation analysis. The mean HADS-depression (HADS-D) and HADS-anxiety (HADS-A) scores significantly improved over time (P < 0.001). The prevalence of depression and anxiety decreased from 36.6% and 41.9% at baseline to 10.8% and 12.9%, respectively, at 3 years postoperatively. The mean HHS increased significantly from 52.3 ± 10.5 at baseline to 88.1 ± 7.2 at 3 years postoperatively (P < 0.001). Significant negative correlations were found between HADS-D/HADS-A scores and HHS at all time points (P < 0.05). The severity of depression and anxiety negatively correlated with functional recovery, highlighting the importance of psychological interventions in the management of patients with FHN.

Rapid recovery after total hip arthroplasty: direct anterior approach combined with PENG block and lateral cutaneous femoral nerve block

Introduction The "gold" standard for the treatment of late stages of coxarthrosis is total hip arthroplasty. Direct anterior approach (DAA) refers to minimally invasive surgical interventions in orthopaedics. Extended anesthetic measures in combination with low-traumatic surgical techniques may reduce postoperative pain and accelerate patient's recovery.The purpose of the study was to compare the recovery times of patients after hip arthroplasty using DAA in combination with PENG block, lateral cutaneous femoral nerve (LCFN) block and without extended anesthetic measures.Materials and methods A prospective randomized comparative clinical study was performed, which involved 62 patients divided into two groups: the study one (n = 29) and the control one (n = 33). In both groups, arthroplasty was performed using DAA. Patients of the study group underwent PENG block and LCFN block. The patients in the control group did not receive extended anesthesia. The evaluation criteria were pain assessment using the visual analogue scale (VAS), administration of painkillers, patient’s mobility and the length of hospital stay.Results The VAS score for pain in the study group were lower than in the control group after 6 hours — 3.7 (3.4; 4.1) and 4.3 (4.2; 4.8); 24 hours after surgery — 3.5 (3.3; 3.6) and 4.1 (3.9; 4.5) (p &lt; 0.001). After 48 hours, the indices were comparable: 3.5 (3.1; 4.1) and 3.7 (3.6; 3.9) (p = 0.19). The rate of requests for pain relief in the first 24 hours was lower in the study group than in the control group: 2 (1; 2) and 3 (2; 3) cases (p = 0.003). The results of the manual muscle test after 6 hours and 24 hours were comparable (p &gt; 0.05). The time interval between the end of the operation and the first walking on crutches was shorter in the study group — 3.1 hours (2.9; 3.4) and 3.98 hours (3.8; 4.2) (p &lt; 0.001). The length of hospital stay was shorter in the study group: 1.5 (1.2; 2) and 2.5 (2; 3) days (p &lt; 0.001).Discussion Lower postoperative pain allows faster activation of patients, thus improving the results of the early rehabilitation period.Conclusion The use of PENG block and LCFN block in arthroplasty with the use of DAA has clinical effectiveness in the first 24 hours, and helps to accelerate the postoperative recovery of patients.

The predictive value of stress-induced hyperglycemia parameters for delayed healing after tibial fracture post-surgery

PurposeThe objective of this retrospective cohort study was to investigate the predictive value of stress-induced hyperglycemia parameters for delayed healing after tibial fracture post-surgery.MethodsA cohort of 108 participants who underwent surgical intervention for tibial fractures caused by trauma was included in this retrospective study. Data collected from electronic medical records encompassed demographic characteristics, bone healing assessments, stress-induced hyperglycemia parameters, inflammatory markers, and stress-related hormones. Comparative analyses, correlation analyses, univariate logistic regression analyses, and receiver operating characteristic (ROC) curve analyses were conducted to assess the predictive value of the studied parameters.ResultsThe delayed healing group exhibited higher levels of fasting blood glucose, postprandial glucose, and HbA1c, as well as elevated levels of inflammatory markers and stress-related hormones compared to the normal healing group. Correlation analysis and logistic regression demonstrated positive associations between stress-induced hyperglycemia parameters, inflammatory markers, stress-related hormones, and delayed union of tibial fractures (R2: 0.183 ~ 0.403;OR: 1.091 ~ 16.332). ROC curve analysis revealed high area under the curve (AUC = 0.911) values for stress-induced hyperglycemia parameters, indicating their potential as predictive markers for delayed healing. Multivariate regression analysis further substantiated the predictive capability of stress-induced hyperglycemia parameters.ConclusionThe study findings highlight the complex interplay between stress-induced hyperglycemia, inflammatory response, and bone healing outcomes in patients undergoing surgical intervention for tibial fractures. The identification of stress-induced hyperglycemia parameters as potential predictive markers for delayed healing after tibial fracture surgery offers insights for risk assessment and patient management, emphasizing the need for comprehensive understanding of these factors to optimize postoperative recovery in orthopedic patients.