Preoperative Preparation Research Articles

The effectiveness of waxing or epilation compared to conventional methods of hair removal in reducing the incidence of surgical site infections: a systematic review and meta-analysis

BackgroundSurgical site infections (SSIs) pose a significant challenge to healthcare systems by elevating patient morbidity and mortality and driving up financial costs. Preoperative skin preparation is crucial for preventing SSIs; however, certain traditional methods of hair removal have been found to increase the risk of SSI development. Mechanical epilation and waxing constitute two relatively explored methods of hair removal, which may hold potential to accelerate wound healing due to the activation of stem cells within hair follicles. This review assesses the efficacy of preoperative hair removal via waxing and mechanical epilation in reducing SSI incidence.MethodsThis systematic review was prospectively registered with PROSPERO (ref: CRD42023423798) and a protocol previously published in a peer-reviewed journal. All findings are reported according to PRISMA guidelines. A comprehensive search of Medline, Embase, CENTRAL, ClinicalTrials.gov and CINAHL. Inclusion criteria encompassed adult patients undergoing any surgical procedure, comparing waxing or epilation against other hair removal methods or no hair removal, with SSI incidence as the primary outcome. There was no restriction on study size or quality to ensure a comprehensive literature evaluation.ResultsThe review found no studies meeting the selection criteria out of 576 records screened.Discussion/conclusionThis review has identified no literature regarding the use of waxing and mechanical epilation as methods of preoperative hair removal. The lack of experimental evidence combined with the potential physiological advantages of these techniques indicate that this could be a valuable area of future research. These techniques may represent novel approaches to SSI prevention, particularly beneficial in high-risk surgical disciplines like vascular surgery.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=423798, PROSPERO (CRD42023423798).

An Essential Infinitebook for Plastic and Reconstructive Surgery Preoperative Planning.

Over the past decade, plastic and reconstructive procedures have notably increased, driven by greater accessibility and aesthetic preferences. Despite surgeons' efforts, patient satisfaction faces challenges due to unrealistic expectations rooted in inadequate knowledge. Preoperative consultations present an opportune moment to address this issue. This study introduces a new approach for preoperative planning: the Infinitebook. Designed to enhance patients' understanding and satisfaction, it facilitates real-time procedure explanations and helps manage expectations. The Infinitebook, a versatile A5-sized notebook-like resource, aids surgeons in illustrating procedures such as abdominoplasty, liposuction, and breast reconstruction, enhancing patient understanding through real-time interaction, personalized illustrations, and sustainable practices, facilitating improved communication in plastic and reconstructive surgery. A cross-sectional study compared 2 groups: 1 using the Infinitebook-assisted explanation approach and another without. A questionnaire evaluated its impact on patients' procedural understanding level and satisfaction with the preoperative consultation. Statistical analysis was conducted using IBM SPSS Statistics. Participants (n = 46) were systematically sampled and categorized by demographics. Two groups (n = 23 each) received preoperative consultations with and without the Infinitebook. Perceptions on aspects of preoperative consultations were assessed. The Infinitebook received positive feedback, with all participants (100%) recommending it. This article introduces the Infinitebook, an environmentally friendly tool enhancing preoperative preparation, patient comprehension, and satisfaction in plastic and reconstructive surgery. It offers a customizable solution with potential for global implementation, with scope for further research. This study lays groundwork for future advancements in preoperative consultations and planning, promoting person-centered healthcare, and integrating new technologies.

Caring for Patients With Pheochromocytomas in the Perioperative Setting: Earn 1.4 Contact Hours.

Pheochromocytomas are rare, complex catecholamine-secreting tumors of the adrenal medulla. Patients with pheochromocytomas may experience episodes of life-threatening hypertension, and untreated tumors can be fatal. The nonspecific signs and symptoms (eg, headaches, palpitations, sweating) make diagnosing these tumors difficult. A comprehensive patient history, clinical evaluation during episodic hypertension, and biochemical test results can facilitate a definitive diagnosis. The only curative treatment is minimally invasive tumor removal. Because the tumor may recur, patients require follow-up visits for approximately 10years after surgery. Preoperative evaluations can include cardiac and imaging studies and genetic testing. Preoperative preparation involves controlling hypertension and planning for hypotension after tumor removal. Perioperative nurses should be prepared to assist anesthesia professionals with placing invasive hemodynamic monitors and responding to blood pressure changes. An interdisciplinary team can create a guideline or protocol for nurses to follow to enhance outcomes when caring for patients with pheochromocytomas.

Standardized surgical procedure of laparoscopic transphrenic approach for Siewert TypeⅡ adenocarcinoma of esophagogastric junction (2024 edition)

In recent years, with the popularization of minimally invasive surgery, laparoscopic transphrenic approach (LTP) surgery for Siewert Type II adenocarcinoma of esophagogastric junction (AEG) has gradually been applied in clinical practice. This technique combines the advantages of transthoracic and transabdominal approaches, achieving a combined operation of the thoracic and abdominal cavities. It can achieve thorough lymph node dissection, safe esophageal resection margin, and reliable digestive tract reconstruction, and has promising application prospects. However, there is no unified standard for LTP surgery at present, which hinders the standardization and further promotion of this technology. Therefore, the Oncology Gastroenterology Committee of China Anti-cancer Association has convened experts from domestic gastrointestinal and thoracic surgery fields, reviewed relevant literature, and combined with clinical practice. After extensive discussions, they formulated the LTP surgical operation standard. This standard encompasses various aspects, including the surgical approach, indications, contraindications, preoperative preparation, operational procedures (encompassing anesthesia, patient positioning, surgeon's stance, abdominal operation port layout, thoracic operation port layout, the Five-Step Maneuver lower mediastinal lymphadenectomy, and digestive tract reconstruction), as well as the prevention and management of specific complications. The aim is to provide a reference for clinical doctors conducting the Siewert Type II AEG radical surgery with LTP.

Our experience in providing anesthesia during surgical interventions for necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is one of the most common serious acquired diseases of the gastrointestinal tract, both in full-term and premature infants, and is associated with a high risk of complications and high mortality. Anesthetic management for necrotizing enterocolitis in newborns during surgery is a complex task and is still relevant, since the future fate of the patient depends on adequacy of the anesthesia used. Purpose of the study: Optimization of anesthesia during surgery in newborns for necrotizing enterocolitis. Material and research methods: The study was conducted in surgical clinics of the Azerbaijan Medical University. The paper presents the results of treatment of 96 patients based on the assessment of clinical indicators of preoperative preparation, anesthesiological care, and the study of central hemodynamics in newborns operated on for necrotizing enterocolitis. Newborns were divided into 2 groups depending on the method of anesthesia used: group I with general anesthesia and group II with general anesthesia using caudal anesthesia. Results: The results of this study showed that effective interruption of nociceptive impulses from the surgical site through caudal blockade and sufficient sedation can prevent pronounced activation of the body's neurohumoral reactions to surgical stress under conditions of balanced regional anesthesia, and it was also revealed that the modern muscle relaxant rocuronium bromide allows the concept of multicomponent anesthesia to be implemented, causing complete relaxation of the striated muscles during surgery, which helps to effectively block pathological reactions in response to surgical stress.

Regulatory Standard for Determining Preoperative Skin Preparation Efficacy Underreports True Dermal Bioburden in a Porcine Model.

Medical device companies and regulatory bodies rely on a nondestructive bacterial sampling technique specified by the American Society for Testing and Materials (ASTM E1173-15) to test preoperative skin preparations (PSPs). Despite the widespread use of PSPs, opportunistic skin-flora pathogens remain the most significant contributor to surgical site infections, suggesting that the ASTM testing standard may be underreporting true dermal bioburden. We hypothesized that ASTM E1173-15 may fail to capture deep skin-dwelling flora. To test this hypothesis, we applied ASTM E1173-15 and a full-thickness skin sampling technique, which we established previously through application to the backs of seven pigs (Yorkshire/Landrace hybrid) following a clinically used PSP (4% chlorhexidine gluconate). The results showed that samples quantified using the full-thickness skin method consistently cultured more bacteria than the ASTM standard, which principally targeted surface-dwelling bacteria. Following PSP, the ASTM standard yielded 1.05 ± 0.24 log10 CFU/cm2, while the full-thickness tissue method resulted in 3.24 ± 0.24 log10 CFU/cm2, more than a 2 log10 difference (p < 0.001). Immunofluorescence images corroborated the data, showing that Staphylococcus epidermidis was present in deep skin regions with or without PSP treatment. Outcomes suggested that a full-thickness sampling technique may better evaluate PSP technologies as it resolves bioburdens dwelling in deeper skin regions.

Epidural Anesthesia in a Patient with Severe Thoracic Kyphosis Undergoing Primary Cesarean Delivery: A Case Report

The administration of neuraxial anesthesia among parturient patients with concomitant spine deformity poses challenges to anesthesiologists. The apprehension stems from the increased possibility of a failed block and complications arising from potential neurologic injury due to anatomic variance. This is a case report of a 30-year old female gravida 1 para 0 at 36 4/7 weeks age of gestation with severe thoracic kyphosis who underwent emergency primary low segment cesarean section under epidural anesthesia. Ultrasonography of the spine was done pre-induction to visualize spinal anatomy and verify anatomic landmarks. Epidural anesthesia was attempted twice before achieving adequate block to dermatomal level T4 within approximately seven minutes. The patient was able to tolerate the procedure well without significant intraoperative events. Fetal outcomes were also favorable with APGAR scores of 9,9. This case report emphasizes that with extensive preoperative evaluation and preparation, an individualized anesthetic plan may be devised. Ultrasound-guided epidural catheter insertion can be a safe option for obstetric patients with thoracic kyphosis.

Thyroid storm in a patient with unknown hyperthyroidism during nonthyroidal surgery—a case report and literature review

BackgroundThyroid storm (TS) is a critical manifestation of hyperthyroidism. In recent years, the risk of perioperative TS is significantly decreased in patients with hyperthyroidism undergoing thyroid surgeries with adequate preoperative preparations. However, those who undergo non-thyroidal operations have higher risk of TS due to easily ignoring the evaluation of thyroid function. The purpose of this case report is to present a patient with TS during nonthyroidal surgery and review similar cases in the literature.Case presentationA middle-aged female who received unilateral total knee arthroplasty under general anesthesia developed refractory tachycardia during the operation and was diagnosed with hyperthyroidism via laboratory tests after surgery. She was suggestive of TS based on the Burch and Wartofsky scoring system and relieved after etiological treatments. She was discharged 10 days after surgery and continued to take antithyroid medication.ConclusionWe recommend that a comprehensive history collection is warranted. The clinical manifestations of TS during operation could be versatile and atypical. Any abnormalities during an operation like abnormal heart rate, blood pressure, body temperature, or even the unusual anesthetics needed, should not be ignored. In surgeries with general anesthesia, it is necessary to be cautious about TS with an atypical manifestation of tachycardia. Once suspected, supportive and resuscitative treatment along with antithyroid medication should be promptly initiated.

BS SO07 - NHS Tertiary Centre Experience with Bariatric Tourism; A Call for National Registry

Abstract Background Bariatric surgery has demonstrated notable efficacy and is becoming an increasingly popular practice. Nonetheless, patients often opt for bariatric tourism due to the unaffordability of bariatric procedures or the lengthy waiting lists. The postoperative care for such patients not only imposes financial burdens on a different health system, necessitating costly interventions for complex cases but also affects the allocation of resources for patients receiving care in the public health services. A national guidance platform and registry are required to measure the impact of bariatric tourism on the modern NHS and plan future resource allocation. Method This is a retrospective review of patients referred to one of the bariatric units in the United Kingdom for complications following bariatric procedures abroad. Patient demographics, bariatric intervention, presenting complications, length of hospital stay and management received were recorded. Results Between 2022 and 2024, our unit admitted nine patients. Eight had sleeve gastrectomy in Turkey, and one had a gastric balloon in Thailand. In the sleeve group, five patients had intractable vomiting, one had small bowel ischemia, one leaked, and one had reactive hypoglycemia. The patient with the gastric balloon had vomiting and abdominal pain, leading to balloon removal. Three sleeve patients had a conversion to Roux-en-Y bypass, one is under investigation, and one is awaiting bypass surgery, one required three surgeries for small bowel ischemia, and one with a leak was treated with a pigtail and gastric stent. Conclusion Medical tourism for bariatric procedures is an appealing option for obese patients due to its affordability and shorter wait times. Patients typically receive brief pre-operative preparation and education in addition to a limited post-operative care. However, managing complex bariatric cases is expensive, necessitates extended hospital stays and nutritional and emotional support, and can only be done in specialised centres. It's important to create a national bariatric surgery guidance platform providing recognised centre details internationally and a national registry of bariatric tourism patients to assess the impact on the healthcare system and to plan for future resource allocation.

Algorithm of surgical treatment of resistant forms of pulmonary tuberculosis

Objective. To improve the effectiveness of surgical treatment of multidrug–resistant pulmonary tuberculosis and extensively drug–resistant pulmonary tuberculosis. Materials and Methods. The work is based on the analysis of the results of treatment of 316 patients. The sequence of actions to determine the optimal type and extent of surgical intervention is regulated. Results. An algorithm for the surgical treatment of multidrug–resistant pulmonary tuberculosis and extensively drug–resistant pulmonary tuberculosis was developed and implemented, based on the results of a study of this complex category of patients who underwent preoperative preparation, a sequence of actions for surgical intervention, and postoperative management technology, taking into account current specific therapy regimens. Conclusions. The application of the developed algorithm of surgical treatment allowed to reduce the incidence of pulmonary tuberculosis recurrence and postoperative complications from (14.4 ± 2.3) to (7.0 ± 1.3)% and cure 92.5% of patients.

The evaluation of the effectiveness of bacterial lysate in preoperative preparation of children with adenotonsillar pathology

In childhood, the occurrence and steady growth of diseases of the nasopharyngeal tonsils, often acquiring a chronic course and occurring with exacerbations and complications, is facilitated by a number of factors. Etiological factors of adenotonsillar diseases in children are both bacterial and viral pathogens, among which respiratory viruses are among the most significant. Herpes virus infections (HVI) play an important role in the development of chronic upper respiratory tract pathology, especially in the cohort of frequently ill children. Representatives of the herpes virus family are characterized by lymphotropic action, long-term persistence in the body, and a tendency to reproduce in cells, leading to a violation of the immune status. The incidence of relapses in the postoperative period during surgical interventions in the ENT organs in children remains high. Herpesvirus etiology of recurrent infectious and inflammatory diseases of the URT (upper respiratory tract) is the leading factor in the ineffectiveness of tonsillotomy, adenotomy, and repeated proliferation of lymphoid tissue in the postoperative period in preschool children. The use of a drug from the group of bacterial lysates before surgery is justified in the treatment of frequently and long-term ill children with adenotonsillar hypertrophy.

Correlation of preoperative CT features with intra- and postoperative parameters of endoscopic resection in patients with gastric submucosal tumor (1~3cm).

Endoscopic resection of gastric submucosal tumors (SMTs) possesses minimal trauma, expedited recovery, and reduced costs. Nonetheless, intraoperative challenges, including imprecise surgical risk assessment, prevail. Hence, we investigated the correlation between preoperative CT observation features and perioperative parameters for predicting outcomes in SMT patients. Subjects diagnosed with SMT and undergoing endoscopic surgery conducted at West China Hospital's Endoscopy Center from September 2019 to October 2023 were retrospectively selected. Endoscopic ultrasonography (EUS) and computer tomography (CT) were utilized for evaluating SMT. The study assessed the correlation between preoperative CT findings and perioperative parameters. Increased lesion size on contrast-enhanced CT correlates with increased operative duration, hospital stay, postoperative antibiotic use. Of utmost significance, we observed a significantly higher intraoperative perforation rate for patients with tumor outgrowth compared to those with lesion involvement of the lumen (96.88% vs 29.11%, P < 0.001). These patients also demonstrated an increased risk of postoperative blood stream infections (P = 0.012), necessitating higher antibiotic grade (P = 0.048), along with prolonged gastrostomy tube retention (P = 0.001) and hospitalization (P = 0.018). In addition, CT provides a more accurate and comprehensive assessment of tumor size (P = 0.037) and growth pattern (P = 0.026) than EUS. CT assessment of tumor size closer to reality than EUS. Importantly, these features can assist in pinpointing lesions with elevated surgical complexity and high risk of complications, leading to improved preoperative preparation, thereby increasing anticipation of surgical risks and reducing incidence of complications.

A IMPORTÂNCIA DA AVALIAÇÃO PRÉ ANESTÉSICA EM PACIENTES HOSPITALIZADOS

Introduction: Pre-Anesthetic Assessment (PAA) is essential for preparing surgical patients. Through it, the anesthesiologist has knowledge about the patient's clinical condition and can then safely plan the best anesthetic technique. Objective: much is said about PAA for elective surgical procedure, however, the objective of this study is to highlight the importance of PAA for hospitalized patients. Methodology: this is a literature review study highlighting the importance of PAA. Final considerations: PAA is crucial for the surgical patient, as it allows optimizing the clinical condition and establishing measures that are fundamental to patient safety and, in a certain way, reducing morbidity and mortality, improving the prognosis of the operated patient and reducing costs with surgery pre-operative preparation.

Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies.

Carcinoid heart disease (CHD) affects right-sided valves and causes significant mortality and morbidity. Even though the pathophysiology of the disease is not entirely understood, it is known that chronic exposure to high levels of circulating serotonin is the main factor responsible for developing valvular heart disease. Cardiac imaging plays a critical role in the management of CHD, so the final diagnosis can be performed through multimodal imaging techniques and the measurement of biomarkers. Moreover, in observational studies, surgical treatment of carcinoid-induced valve disease has been found to improve outcomes. Despite advancements in pre-operative preparation in recent years, mortality rates remain high in elderly patients and those with multiple comorbidities due to the risk of intra-operative carcinoid crisis and high post-operative bleeding. In this comprehensive review, we will analyze the causes of carcinoid syndrome and how it can result in severe right heart failure. The role of different imaging modalities in detecting heart valve disease will be discussed together with the therapeutic options at our disposal, such as medical treatment, surgery, and the novel role of transcatheter intervention.

Association between duration of phenoxybenzamine use and postoperative delirium in suspected adrenal pheochromocytoma: a retrospective cohort study.

At present, the available evidence regarding the relationship between duration of phenoxybenzamine use and postoperative delirium is inadequate in suspected adrenal pheochromocytoma. To understand how changes in the duration of phenoxybenzamine use may affect postoperative delirium. The secondary objective of this study is to explore how the duration of phenoxybenzamine use may jointly influence postoperative delirium together with other interacting variables. We conducted a retrospective cohort study involving 527 participants with a preoperative diagnosis of suspected pheochromocytoma. CT characteristics, preoperative preparation, intraoperative infusion, estimated bleeding, use of intraoperative vasoactive drugs, and outcomes were obtained from all participants. Logistic regression and interaction effects were utilized to substantiate the research objectives. A total of 108 (20.5%) developed postoperative delirium, which was seen in 37 (18.0%) in the pheochromocytoma group and 71 (22.0%) in the non-pheochromocytoma group. The incidence of postoperative delirium showed no statistically significant differences in the two groups. A positive association between the duration of phenoxybenzamine use and the risk of postoperative delirium was observed (OR = 1.05, 95%CI = 1.03-1.08, p < 0.01), independent of confounders. The relationship between the duration of phenoxybenzamine use and postoperative delirium differed according to the presence or absence of pheochromocytoma, suggesting an interactive effect (p < 0.05). This study highlights the influence of inappropriate duration of phenoxybenzamine use on the risk of incident postoperative delirium, independent of confounders. The effect of duration of phenoxybenzamine use causes a further increase in the risk of postoperative delirium, especially in non-pheochromocytomas.

Undifferentiated embryonal sarcoma of the liver masquerading as a cystadenoma in a young adult: a case report

BackgroundUndifferentiated embryonal sarcoma of the liver is an infrequent hepatic malignancy, primarily observed in the pediatric population. This neoplasm is exceedingly rare among adults. Despite its scarcity in adult cases, it remains imperative to accurately discern undifferentiated embryonal sarcoma of the liver utilizing diverse imaging modalities to prevent misdiagnosis with more prevalent benign and malignant hepatic masses. In this case, a comprehensive imaging examination was conducted, encompassing ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography–computed tomography scans. Notably, the positron emission tomography–computed tomography scan revealed 18F-fluorodeoxyglucose uptake characteristics indicative of malignancy, providing a pivotal clue for prompt diagnosis of undifferentiated embryonal sarcoma of the liver.Case presentationThis report presents the diagnostic procedure employed for a 37-year-old female patient of Han ethnicity in China diagnosed with undifferentiated embryonal sarcoma of the liver. The patient was admitted with a 2-day history of mid-upper quadrant abdominal pain. The patient’s temperature and inflammatory markers, such as white blood cell count and hypersensitive reactive protein, were slightly elevated. Ultrasound showed a cystic–solid nodule in the liver. The computed tomography revealed a cystic mass in the right lobe of the liver, characterized by a low-density shadow and a lack of significant enhancement during contrast-enhanced scanning, initially suggesting cystadenoma. Enhanced magnetic resonance imaging revealed a block-like abnormal signal shadow in the right hepatic lobe, suggestive of various etiologies, including benign lesions, cystadenoma with hemorrhage, or hemangioma with hemorrhage. However, the positron emission tomography–computed tomography showed increased 18F-fluorodeoxyglucose consumption within both the cystic wall and lesion, raising suspicion of malignancy. Surgical resection of the posterior hepatic lobe was performed under general anesthesia after comprehensive preoperative preparations. During the procedure, a space-occupying lesion was identified in the right posterior hepatic lobe, adhering to the diaphragm. Surface liver parenchyma overlying the tumor exhibited rupture, with several blood clots visible. The tumor was successfully and completely excised. Pathological examination revealed a fusiform cell tumor, necrosis, hemorrhage, cystic changes, cellular atypia, mitotic images, and eosinophilic globules suggestive of undifferentiated embryonal sarcoma of the liver. Immunohistochemical staining indicated CK (+), vimentin (Vim; +), Desmin (+), actin (−), α1-AT (+), GPC-3 (+), PDGFRa (+), MDM2 (+), P16 (+), Ki-67 (+) 30–35%, and PAS (+). The patient underwent five cycles of combination chemotherapy with ifosfamide and epirubicin, administered at 21-day intervals at our hospital. Following 3 years of postoperative surveillance, the patient remained stable, with no evidence of hepatic tumor recurrence.ConclusionOn the basis of this case and a comprehensive literature review, we recommend that clinicians consider the possibility of undifferentiated embryonal sarcoma of the liver in patients presenting with non-specific clinical and serological markers, particularly when there is inconsistency between ultrasound and computed tomography imaging findings, along with elevated 18F-fluorodeoxyglucose uptake observed in both the cystic wall and lesion on positron emission tomography–computed tomography examination. Given the rarity and high-grade malignancy of undifferentiated embryonal sarcoma of the liver, heightened clinical awareness and recognition are crucial for early diagnosis and successful therapy.

Comparative evaluation of chlorhexidine gluconate with alcohol and polyhexamethylene biguanide with Tris-EDTA as antiseptic solutions for pre-operative skin preparation in dogs

Background and Aim: Skin antisepsis plays a crucial role in pre-operative skin preparation, with chlorhexidine gluconate and alcohol being historically the preferred choice. However, concerns have risen regarding the development of bacterial resistance to chlorhexidine. Polyhexamethylene biguanide (PHMB) combined with Tris-ethylenediaminetetraacetic acid (Tris-EDTA) has recently emerged as a skin and wound antiseptic. This study aimed to compare the antibacterial efficacy and local safety of 2% chlorhexidine gluconate with 70% alcohol (CG+Alc) and 0.3% PHMB with 6% Tris and 1.86% EDTA (PHMB+Tris-EDTA) for pre-operative skin preparation in dogs. Materials and Methods: Twenty-four adult dogs underwent aseptic preparation on both sides of their ventral abdomens, with one side receiving CG+Alc and the other side receiving PHMB+Tris-EDTA, assigned randomly. Skin swab samples were collected pre-antisepsis and at 3-, 10-, and 60-min post-antisepsis to quantify bacterial colony-forming units (CFUs). Local skin reactions (erythema and edema) were evaluated after hair clipping, pre-antisepsis, and at 3-, 10-, 30-, and 60-min post-antisepsis. Results: There was no significant difference in bacterial CFU counts between the two antiseptic groups pre-antiseptic. Both solutions significantly reduced CFU counts (p &lt; 0.05) at all post-antisepsis sampling times compared with pre-antisepsis. However, dogs treated with PHMB+Tris-EDTA showed a significantly higher incidence of edema at 10 min (p = 0.02) and 30 min (p = 0.003) and a higher incidence of erythema at 10 min (p = 0.043) post-antisepsis compared with CG+Alc. No skin reactions were observed in either group at 60 min post-antisepsis. Conclusion: CG+Alc and PHMB+Tris-EDTA reduced bacterial counts in pre-operative skin preparation in dogs. However, acute transient skin reactions were observed more frequently following the application of PHMB+Tris-EDTA. Keywords: alcohol, antisepsis, chlorhexidine gluconate, dogs, polyhexamethylene biguanide, skin preparation, tris-ethylenediaminetetraacetic acid.

Autologous Ovarian Tissue Transplantation: Preoperative Assessment and Preparation of the Patient.

Ovarian tissue cryopreservation (OTC) is an innovative and established fertility preservation method. More than 150 live births have been reported worldwide to date with the use of this strategy. OTC is one of the options to preserve fertility in prepubertal girls and for women who have time constraints and/or contraindications for ovarian stimulation for oocyte/embryo freezing before cancer treatment. The success rate of the ovarian tissue transplantation (OTT) depends on many interrelated factors. Therefore, preoperative evaluation and preparation of the candidate patients for the procedure are of paramount importance. In this review, our aim was to provide a guide for the clinicians, which demonstrates step-by-step assessment and preparation of the patients and ovarian tissue samples for transplantation. We searched for published articles in the PubMed database containing key words, such as OTT, OTC, preoperative assessment, primordial follicle density, and cancer, in the English-language literature until May 2024. We did not include abstracts or conference proceedings. OTT is still a developing method as an effective fertility preservation approach. It is essential to perform a thorough preoperative evaluation of the patient to improve the success rates of transplantation. Preoperative evaluation and preparation of women for ovarian transplantation surgery should include safety management to prevent reimplantation of malignant cells, transplanting ovarian tissue with minimum follicle loss and the decision of the best transfer site.

RETRACTION: The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta-analysis.

M. Chen , J. Lin , D. Miao , X. Yang , M. Feng , M. Liu , L. Xu , Q. Lin , "The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta-analysis," International Wound Journal 21, no. 4 (2024): e14884, https://doi.org/10.1111/iwj.14884. The above article, published online on 23 April 2024, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. Following an investigation by the publisher, the parties have concluded that this article was accepted solely on the basis of a compromised peer review process. Therefore, the article must be retracted. The authors disagree with the retraction.

Robotic-Assisted Adrenalectomy of a Giant Dopamine-Only Secreting Pure Adrenal Ganglioneuroma: A Case Report and Operative Video

Introduction: Ganglioneuromas (GNs) are rare, differentiated tumors that originate from neural crest cells and can occasionally develop in the adrenal medulla. Adrenal GNs (AGNs) are typically hormonally silent and asymptomatic. Hormone-secreting pure AGNs in adults are uncommon; however, dopamine-secreting pure AGNs are extremely rare, with only a few cases reported in the literature. Giant AGNs are usually managed with open surgical intervention. Case Presentation: We present a case of a giant dopamine-secreting pure AGN in a 19-year-old woman who complained of mild left flank pain with no other symptoms. On physical examination, a mass was felt in left upper abdomen. MRI showed a left retroperitoneal mass extending from the left suprarenal region inferiorly, anterior to and compressing the left kidney, measuring 9 × 7.5 × 14 cm. Hormonal investigations ruled out Cushing syndrome, and catecholamine studies were negative for metanephrines, normetanephrines, adrenaline, and noradrenaline but were positive for dopamine levels more than 3 times the upper normal level. The patient underwent robotic-assisted adrenalectomy with minimal morbidity. Conclusion: Robotic-assisted adrenalectomy is a feasible and effective treatment option for rare dopamine-secreting pure AGNs. Careful patient selection and thorough preoperative preparation are essential to minimize risks and ensure favorable outcomes.