Repair Time Research Articles

ROLE OF WOUND DRAINS VS ABDOMINAL BINDER AND PERCUTANEOUS ASPIRATION AFTER OPEN REPAIR OF VENTRAL HERNIA USING POLYPROLENE MESH

Background: Abdominal wall hernias are among the most common of all surgical problems. Ventral hernia repair (VHR) is a commonly performed operation so hernia defect size affects operative time and surgical technique for repair of a ventral hernia. Incisional hernia is the most frequent postoperative complication following general surgery. Complications of ventral hernia repair include seroma, hematoma, wound infection, bowel injury, bowel obstruction, recurrence whether earlyorlate,the mostcommoncomplicationisseroma formation.New advances in the management of ventral hernias including different methodsofrepaireitheropenor laparoscopic and differentmesh types: non-absorbable partially absorbable and absorbable. Objectives: This study was done to review and assess thedifference between insertion of wound drain and the use of abdominal binder and percutaneousaspirationafteropenrepairofventralherniasanditseffect on postoperative outcome. Patients and Methods: A total of 100 patients with non-complicated abdominal wall (ventral) hernia were enrolled to review andassess the difference between insertion of wound drain and the use of abdominal binder and percutaneous aspiration after open repair of ventral hernias and its effect on postoperative outcome. Patients were divided into two groups: Group (A) includes 50 patients with insertion of wound drain. Group (B) includes 50 patients with application of abdominal binder immediately postoperatively for 2 weeks. Results: This study showed distribution of patients according to age, ranging from 27 years to 70 years with mean age of 49.2 years (±11.6 years).25% of patients below 39, 50 % of patients below 50 and 75% ofpatientsbelow59.75.Inourstudy,60%ofoperationswerecarriedout under spinal anesthesia and 40% of operations were carried out under general anesthesia. Out of 100 patients of our study, in 28 % of cases, the hernial content was intestine and in 72 of cases the hernial content wasomentum.Outof100patientsofourstudy,therewasdevelopingof significant seroma in (30%) of patients as follow: (17%) at group A (with drain)& (13%) at group B (without drain). Significant seroma was not seen in (70%) of patients. Wound infection was developed in (18%)ofpatientsasfollow(12%)forgroupA(withdrain)and(6%)for groupB(withoutdrain).Woundinfectionnotseenin(82%)ofpatients. Out of 100 patients of our study, (2%)oftotalcountonlyshowing earlyrecurrencethatpresentat group B. (9%) of total count only complained of persistent postoperativepainasfollows, 6 cases fromgroup (A) and 3 casesfrom group (B). Mean hospital stay was 1.46 days for group (A) and 1.26 daysforgroup(B).Meanperiodbeforereturningto normalactivitywas 3.7weeksforgroup(A)and2.9weeksforgroup(B). Conclusion: Combined abdominal binder and percutaneous aspiration for selected caseswere superior to insertionof wound drains asregards seroma formation, wound infection and postoperativereturn to normal activity with no significant difference as regards hematoma, postoperative pain, hospital stay andpatientsatisfaction.

Ventricular septal defect complicating anterior acute myocardial infarction : A Case of transcatheter closure

IntroductionPost-infarction ventricular septal defect (PIVSD) is one of the most serious mechanical complications of acute myocardial infarction (AMI). Over the last decade, percutaneous closure is increasingly undertaken, with results similar to cardiac surgery. We present a case of ST-elevated anterior AMI, complicated by apical PIVSD successfully treated with transcatheter closure. Case ReportAn 83-year-old man was hospitalized for chest pain occurred 18 hours before, during the night time. He was an active smoker. Clinical examination revealed normal heart sounds and pulmonary bibasilar crackles. ST-segment elevation with deep T waves inversion in anterior leads were detected on the electrocardiogram. A mildly-reduced ejection fraction (40%) was found by transthoracic echocardiogram. The patient underwent emergency coronary angiography, which revealed a subocclusive stenosis of the mid left anterior descending artery with a TIMI 2 flow, treated by balloon angioplasty and drug-eluting stent. Four days after revascularization, the patient developed an acute deterioration with signs of decompensated heart failure and a new holosystolic murmur with large irradiation. Inotropic agents’ administration was required to maintain a precarious hemodynamic condition. A bedside Echo revealed an apical VSD, measuring 15 × 10 mm, with left-to-right shunting, and pulmonary hypertension. The patient was scheduled for transcatheter PIVSD closure. The procedure was performed under fluoroscopic guide. Two vascular access sites were placed, femoral arterial and right internal jugular vein. Through the right internal jugular vein, a 24-mm Amplatzer atrial septal occluder on a 9 French Amplatzer TREVISIO™ intravascular delivery system was advanced via right ventricle into the PIVSD. Contrast fluoroscopy was used to assess apposition and the degree of shunt reduction before release. Echocardiographic evaluation performed 48 hours later confirmed a correct apposition of the device with insignificant residual shunt. At 6 months follow-up, he was asymptomatic, with unchanged prosthetic findings. ConclusionPercutaneous closure has been emerged as a valid cost-effective alternative to surgery and should be advised. However, debate remains on the optimal preprocedural optimization, timing of repair and modality of treatment.

The Benefit of Open Rives-Stoppa Procedure in Complex Incisional Hernia.

Introduction: Ventral hernia is one of the most common general surgical pathologies. An incisional hernia will develop in 10–15% of patients with an abdominal incision, and the risk increases to up to 23% in those who develop surgical site infections.
 Ventral hernia repairs are mostly elective (90%) procedures, but the repair methods are highly variable.
 Popularized in Europe by Rives and Stoppa, the retromuscular technique has proven to be very effective, with a 94.2% probability of having the lowest odds for recurrence and a 77.3% probability of having the lowest odds for SSI.
 The study aimed to evaluate our experience at a secondary care center performing Rives-Stoppa repair for abdominal ventral and incisional hernias.
 Materials and Methods: Between April 2019 and August 2021, 46 patients in the practice at a secondary regional hospital, Teni Konomi, Korce, Albania, underwent a Rives-Stoppa incisional hernia repair.
 Results: There were 14 (31%) males and 32(69%) females (age range 31-75).
 Most incisional hernias were midline xiphoid-pubic incision and supraumbilical, with several subcostals (2 right and 1 left) hernias.At the time of repair, most incisional hernias were symptomatic and evident on physical exam. In four cases, the hernia sac was incarcerated at the presentation time.
 Conclusion: The Rives-Stoppa technique has excellent long-term results and low morbidity in patients with large primary or recurrent incisional hernias. It is the gold standard for most surgeons.
 Keywords: Incisional Hernia, mesh, polypropylene, abdominal wall surgery, rectus muscle

Optimal selection and analysis of microgrid energy system using Markov process

This study investigated the reliability of a microgrid (MG) energy system using the Markov process reliability method. Twenty possible MG configurations based on photovoltaic (PV), wind turbine generator (WTG), biomass generator (BMG), battery bank (BB), diesel generator (DG) and an electric vehicle (EVs) have been considered. This study also selects an optimal configuration based on reliability indices (failure rate, repair time, unavailability, expected energy not supplied (EENS) and loss of load probability (LOLP)), annually load demand, availability of the system and its components. The results show that the hybrid PV/WTG/BMG/BB/EVs/DG microgrid system has the lowest system failure rate (0.01012 /year), repair time (1.1858 hrs), unavailability (0.0120 hrs/year), EENS (4.5 kWh/year) and LOLP (1.36986E-06 /year). This MG configuration has an availability of 99%. The PV array (97.55%) and the changeover switch (99.5%) are the parts of the MG system that are the most reliable. The least stable elements of an MG system are battery (63.64%), diesel generator (80%) and biomass generator (83.89%). PV (62%) and WTG (28% of total) are the main contributors to electricity generation, with the battery, electric vehicles, and diesel generator acting as backup sources. Under different weather and load conditions, the hybrid PV/WTG/BMG/EVs/BB/DG microgrid was found to be a reliable and efficient system for remote areas. This research carries a significant impact for policymakers, government, energy planners, and researchers working on stand-alone microgrid systems as it provides valuable insights into optimizing system configuration for reliability and efficiency.

Epoxy/polytetrafluoro-wax composite coatings demonstrate remarkable wear resistance, offering rapid and durable cyclic self-healing capabilities facilitated by the “sweating” behavior of polytetrafluoro-wax

Self-healing materials possess the remarkable ability to mend scratches or cracks in damaged material sections. However, there is a pressing need to enhance the repair time and sustainable repair capability of existing self-healing materials. In this study, by physical mixing epoxy resin (EP) and polytetrafluoro-wax (PFW), we have successfully synthesized an EP/PFW composite coating. At a temperature of 120 °C, PFW, with its low melting point, undergoes rapid “sweating” (phase change) and migration to damaged regions within the coating. This EP/PFW composite coating demonstrated outstanding efficiency in repairing scratches on various substrates, with an average repair time of a mere 77 s. The addition of PFW also resulted in a substantial reduction in the coating's coefficient of friction (79 %) and wear coefficient (64.8 %). Moreover, the EP/PFW composite coating exhibited excellent sustainable self-healing properties, retaining its impressive tribological characteristics even after undergoing 5 wear/healing cycles.

Component-based estimation of recovery time and time-related expenses after hurricane events

Introduction: Due to hurricane damage, building residents or businesses must be relocated during the recovery time, which leads to time-related expenses (TRE), also known as additional living expenses (ALE) or extra expense coverage (EEC) or business interruption insurance (BIC). TRE are difficult to predict since they depend on the damage and time necessary to repair the building as well as on external factors such as damaged utilities and the availability of labor and materials, among other issues.Methods: In this study, we developed a new TRE hurricane vulnerability model for mid/high-rise buildings. The model combines estimates of repair time (Trepair), delay time (Tdelay), and utilities downtime (Tdown) to predict overall recovery time (Treco).Results: The outputs of the model include 1) TRE vulnerability matrices, which yield probabilities of Trepair, Tdelay, Tdown, Treco, and TRE conditional on either maximum 3-s wind speed or overall building damage ratio; 2) the corresponding vulnerability curves, which yield the mean values as a function wind speed or damage ratio.Discussion: Insurers can use these results to project TRE, and emergency managers and urban planners can use the recovery times to characterize the resilience of coastal communities. This paper summarizes the methodology and illustrates its implementation and results. The selected results of Treco are compared with the recovery times provided using the HAZUS-MH Hurricane Model.

Optimization of a preventive maintenance strategy for a product with limited repair times

This paper proposes a base warranty and replacement warranty strategy for repairable products. It should be emphasized that the product failure rate is low in the early stage of the base warranty. Therefore, in order to reduce the manufacturer’s maintenance cost, the manufacturer does not carry out preventive maintenance in the early stage of the base warranty, and carries out regular preventive maintenance in the later stage of the base warranty. At the same time, if the number of product failures in the base warranty exceeds the specified limit, the manufacturer must replace products for customers free of charge according to the warranty contract. After the product is replaced, if the number of product failures does not exceed the limit, the manufacturer will continue to provide customers with the remaining base warranty period of the original product, and the warranty period will continue to be extended for a period of time. By minimizing the expected cost rate, it is shown that the optimal maintenance policy for warranty products is unique. Finally, we give a numerical example and study the effects of periodic preventive maintenance and other relevant parameters on the optimal solution.

Simulation-based variable neighborhood search for optimizing skill assignments in multi-server facilities with inventories

This paper addresses the joint optimization problem of skill assignments and inventory in a multi-skill, multi-server repair facility. Failures of different part types occur according to Poisson processes, and each part type requires a certain repair skill. The repair facility supplies ready-to-install spare parts when available in the inventory, according to the (S−1,S) inventory policy. The repair times follow exponential distributions, with rates dependent on the part type. After repair, the parts are returned to the inventory as ready-to-install spare parts. If the inventory is empty when a failed part arrives, the replacement part is backordered, and a penalty cost is incurred. The objective of the problem is to find an assignment of repair skills to servers and inventory levels that minimize the expected total cost of the system. That is, the costs for servers, the costs to upgrade the skills of servers, and the expected holding and backorder costs. We propose to solve this problem by a simulation-based Variable Neighborhood Search (VNS) approach, in which a Discrete Event Simulation is applied to evaluate the expected backorder and holding costs given the skill assignments.The proposed method is capable of significantly improving the results of a recently published Genetic Algorithm, achieving an average cost reduction of 5.1% in the same running time. Moreover, it is able to find comparable solutions in one fifth of the GA running time.

Automatic detection of nostril and key markers in images

In the medical field, one of complex challenges in surgery involving the skin, cartilage, mucosa, and the skeletal platform is the cleft nasal deformity. The causes of deformity are nasal formed from improper fusion of the medial and lateral nasal prominences with the maxillary prominence during embryologic development. Primary rhinoplasty or first time of cleft nose repair is the nasal surgery for repairing the cleft nasal deformity. In post cheiloplasty, the primary rhinoplasty patients must use nasal splint for supporting surgical wound. However, regular nasal splints are expensive and only come with default nasal size. This limits nasal splint from supporting specific patient cases such as children. The goal of this study is to implement a program that can automatically detect the nostril and green marker in patient images for creating custom-made 3D nasal splints. The proposed method is created utilizing the CNN model. YOLO architecture is utilized because it is the one of several CNN architectures that works well with the face recognition task. The YOLOV5, YOLOV8, and YOLO-NAS are attempted and compared in the training phase. The model with a highest performance is selected, and fine-tuned for adjusting to be compatible with a patient dataset. The fine-tuned YOLOV8 reaches a mAP with 99.5%. The predicted images from fine-tuned model are used to perform body part segmentation like Otsu's thresholding and discover contour to locate essential features like the green marker and nostril in ellipse and bounding boxes. The nostril distance is calculated using the bounding box and ellipse. The columella distance or nostril gap is measured from the distance between nostrils in YOLO predicted label. Both distances are converted into centimeter scale and evaluated with ground truth value in volunteer and patient cases from nasal expert for inspecting efficiency between bounding box, ellipse, and size of marker. The result proves that the proposed model can detect crucial features with mean absolute error 0.102. Furthermore, the proposed model indicates that marker size has no effect on detection and distance, according to the findings of the experiments.

To use a simple hernia needle for single-port laparoscopic percutaneous inguinal hernia repair in children: a 5-year experience study.

The aim of this study is to investigate the technique and practical significance of using a simple hernia needle in single-port laparoscopic herniorrhaphy in pediatric patients. The study conducted a retrospective analysis of all pediatric patients who underwent treatment for inguinal hernia using single-port laparoscopic herniorrhaphy with a simple hernia needle at Yellow River Sanmenxia Hospital from June 2018 to May 2023. The medical records of all the children were collected, and clinical characteristics, procedural information, and follow-up data were carefully reviewed. A total of 848 patients underwent inguinal hernia repair, with ages ranging from 7 months to 13 years (2.99 ± 2.49 years), including 756 males and 92 females. A total of 528 cases of unilateral hernia and 310 cases of bilateral hernia were reported, with intra-operative findings revealing contralateral occult hernia in 253 cases. Single-port laparoscopic herniorrhaphy was successfully completed in all patients, with no instances of conversion to open surgery. The mean operation time for unilateral hernia repair was (7.50 ± 4.80) min, while for bilateral hernia repair it was (11.55 ± 7.27) min. Five patients presented with subcutaneous emphysema, while two patients experienced a recurrence of inguinal hernia. No complications, such as scrotal hematoma, trocar umbilical hernia and testicular atrophy, were observed. The duration of the follow-up period ranged from 3 to 24 months. The promotion and utilization of single-port laparoscopy combined with a simple hernia needle in clinical practice are justified. Our initial investigation indicates that this surgical approach is both safe and dependable for the management of pediatric inguinal hernia. The procedure presents numerous benefits, including the utilization of uncomplicated instruments, straightforward operation, a clear curative impact, minimal tissue damage, rapid recovery, and the absence of scarring.

Moving toward point-of-care surgery in Ukraine: testing an ultra-portable operating room in an active war zone.

In conflict zones, providers may have to decide between delaying time-sensitive surgeries or performing operative interventions in the field, potentially subjecting patients to significant infection risks. We conducted a single-arm crossover study to assess the feasibility of using an ultraportable operating room (U-OR) for surgical procedures on a porcine cadaver abdominal traumatic injury model in an active war zone. We enrolled participants from an ASSET-type course designed to train Ukrainian surgeons before deployment to active conflict zones. They performed three standardized consecutive abdominal surgical procedures (liver, kidney, and small bowel injury repair) with and without the U-OR. Primary outcomes included surgical procedurecompletion rate, procedure time, and airborne particle count at the start of surgery. Secondary survey-based outcomes assessed surgery task load index (SURG-TLX) and perceived operative factors. Fourteen surgeons performed 76 surgical procedures (38 with the U-OR, 38 without the U-OR). The completion rate for each surgical procedure was 100% in both groups. While the procedure time for the liver injury repair did not differ significantly between the two groups, the use of the U-OR was associated with a longer time for kidney (155 vs. 56s, p = 0.002), and small bowel (220 vs. 103s, p = 0.004) injury repair. The average airborne particle count within the U-OR was substantially lower compared to outside the U-OR (6,753,852 vs. 232,282 n/m3, p < 0.001). There was no statistically significant difference in SURG-TLX for procedures performed with and without the U-OR. The use of the U-OR did not affect the procedure completion rate or SURG-TLX. However, there was a marked difference in airborne particle counts between inside and outside the U-OR during surgery. These preliminary findings indicate the potential feasibility of using a U-OR to perform abdominal damage-control surgical procedures in austere settings.

Epidemiological, anatomoclinical, and therapeutic profile of obstetric fistula in the Democratic Republic of the Congo: About 1267 patients.

Our aim is to describe the epidemiological, anatomoclinical and therapeutic profile of obstetric fistula (OF) in the Democratic Republic of the Congo (DRC). This was a descriptive retrospective study that collected 1416 obstetric fistulas in 1267 patients in seven provinces of the DRC, treated between January 2017 and December 2022. The variables studied were epidemiological, anatomoclinical and therapeutic. The mean age of patients at the time of surgical repair was 33.2 years (range: 15 and 77 years) and 32.8% of patients were aged between 20 and 29 years. The mean age of the fistula at repair was 10 years (range: 3.5 months and 56 years). At the time of fistula, 61.7% of patients had delivered vaginally and 28.7% by caesarean section and 8.2% of patients had a haemostasis hysterectomy. Labour lasted at least 3 days in 47.3% of these patients for the fistula birth. Deliveries took place either at home (27.4%) or in a health facility (72.6%); 83.6% of newborns resulting from these births had died. Taken as a whole, urogenital fistulas are more common than genito-digestive fistulas. Urethro-vaginal (26.2%) and vesico-uterine (24.7%) anatomoclinical entities were predominant among urogenital fistulas. A total of 1416 fistulas were surgically repaired in 1267 patients. These repairs were successful for 1226 (86.6%) fistulas. The main surgical route used was transvaginal (68.8%). In the DRC, obstetric fistula is common in young adult women. It often results from vaginal delivery, after prolonged labour. Fistula births often result in the death of newborns. Uro-genital obstetric fistulas are the most frequent with predominance of urethro-vaginal and vesico-uterine anatomoclinical entities. Fistulas remain untreated for a long time. Mostly done transvaginally, surgical repair gives a good result.

Integration of Process Modeling and Six Sigma for defect reduction: A case study in a wind blade factory

The energetic and environmental crisis currently being experienced around the world has brought an exponential growth on the demand for wind energy, and, consequently, real challenges for companies in this sector. Since this industry is relatively new, its production processes require a significant amount of human intervention and have a high variability in the process and high lead times. Therefore, there is a need to focus on the quality of the processes and their improvement. This paper presents the use of the Six Sigma DMAIC approach integrated with Business Process Management, to reduce the number of defects and the repair time in a leading wind blade manufacturing company in Portugal. During the measurement and analysis phases, data was collected to understand the performance of the process and to identify the main problems and their causes. The data was analysed through several graphical and statistical techniques. In the analysis phase, process modeling was also utilized, using Business Process Model and Notation, to identify the critical steps that are responsible for producing the majority of defects. One month after beginning to use this approach, it was possible to notice a reduction in the number of defects by more than 30%, in the repair time by 14%, and an increase in the process sigma level by more than 100%. Thus, this hybrid approach has allowed the company to become more competitive and responsive to the constant growth in demand.

Modeling Expected Failure Considering Repair Time and Degradation: A Rail System Case Study

Modeling Expected Failure Considering Repair Time and Degradation: A Rail System Case Study

Optimization of Emergency Resource Dispatch for Overseas Long-distance Natural Gas Pipeline Leaks

Overseas long-distance natural gas pipelines usually span across multiple regions or even countries, facing more severe environmental conditions and more prone to leakage and other accidents, and the study of the optimization method of emergency resource scheduling for overseas long-distance natural gas pipeline leakage accidents can help to reduce the casualties and property losses. Therefore, this paper establishes an emergency resource scheduling model in line with the emergency disposal mechanism of overseas long-distance natural gas pipeline leakage accidents, takes into account the variability of the operating ability of maintenance personnel, and improves the accuracy of the scheduling program to a certain extent, and also considers the actual environment of overseas long-distance natural gas pipelines, takes into account the impact of landslides on the emergency scheduling time, and calculates the probability of landslides occurring in the landslide point by using the interpolated value of rainfall The rainfall interpolation is used to calculate the probability of landslide at the landslide point, and the emergency dispatching time is corrected to make the dispatching program more in line with the actual demand. The analysis of the results shows that the emergency resource scheduling time is dominant in the case of small amount of maintenance and repair work and short total maintenance and repair time.

Optimized strategy to improve the outcomes of acute type A aortic dissection with malperfusion syndrome

BackgroundThe mortality of acute type A aortic dissection (ATAAD) with malperfusion syndrome (MPS) is high. However, the management strategy remains controversial. We aimed to evaluate the strategy for MPS at our institution. MethodsAmong 724 patients with ATAAD, 167 patients with MPS were treated with immediate central repair (first stage) or an optimized strategy (second stage). In the second stage, the optimized strategy used was based on 6-hour threshold from symptom onset. For MPS with symptom onset within 6 hours, immediate central repair was performed, followed by endovascular reperfusion if malperfusion persisted. With symptom onset beyond 6 hours, individualized delayed central repair was performed. We compared outcomes between the first and second stages. ResultsThe in-hospital mortality of ATAAD was significantly decreased when the optimized strategy was used (4.3% in the second stage vs 12.5% in the first stage; P < .01). In the second stage, the in-hospital mortality for MPS was decreased (10.2% vs 33.9%; P < .01). Moreover, the in-hospital mortality for MPS with symptom onset within 6 hours and beyond 6 hours decreased from 24% to 7.5% and from 41.2% to 11.8%, respectively. The operative mortality of MPS in the second stage was comparable to that in patients without MPS (4.0% vs 2.4%; P > .05). ConclusionsThe optimized strategy significantly improved the outcomes of MPS. The 6-hour threshold from symptom onset could be very useful in determining the timing of central repair. For patients with MPS symptom onset within 6 hours, immediate central repair is reasonable; for those with symptom onset beyond 6 hours, individualized delayed central repair should be considered.

Fundoplication at the time of paraesophageal hernia repair may not reduce postoperative reflux

Hiatal hernias are observed in approximately 15% to 20% of the population in Western society. Most patients are diagnosed with a sliding-type hiatal hernia, of which gastroesophageal reflux is the predominant driving symptom. Surgical repair of these types of hernias often involves a wrap procedure during the index operation as standard of care. For type 2, 3, and 4 hernias, also known as paraesophageal hernias (PEHs), the symptom complexes vary and often involve symptoms other than reflux, including dysphagia, anemia, shortness of breath, and chest pain. We sought to evaluate whether patients who underwent PEH repair without fundoplication reported different rates of postoperative symptoms compared with those who did.

Дослідження шляхів підвищення оперативності виконання діагностичних операцій електронних систем автотракторної техніки

The purpose of this study is to find ways to reduce production time spent on diagnostic operations during maintenance or repair of electronic control systems (ECS) in automotive vehicles. Existing methods of diagnosing engine control systems in vehicles are sufficiently effective, but in most cases, they require highly skilled personnel, the use of additional complex and expensive equipment, prolonged service cycles, which in turn increases the complexity of maintenance, and also does not provide for prior prediction of faults and system failures. Analysis of scientific publications has shown that to reduce the time for maintenance and repair of electronic systems, it is necessary to predict the residual life of ECS components in vehicles during maintenance, to further reduce the labor intensity of diagnostics and current repairs. In other words, diagnostics performed during maintenance or repair should include predicting the residual life of electronic system components. For the most critical ECS components in vehicles, it is proposed to apply a strategy of replacing them upon reaching a certain mileage, rather than upon failure. This organization method will reduce vehicle downtime in repair and reduce the time to troubleshoot ECS component failures. A method has been proposed for identifying design elements that limit the reliability of the ECS, taking into account the degree of influence of their failures on the engine's technical and economic characteristics and the cost of restoring its performance. The availability of such information is the basis of the ECS maintainability support system. An algorithm has been developed to search for hidden faults in the components of ECS subsystems, which includes predicting the failure of ECS components. This will help reduce the labor intensity of diagnostic operations during maintenance and repair.

The Timing of Primary Neurosurgical Repair and Wound-Site Infection in Children with Myelomeningocele

The Timing of Primary Neurosurgical Repair and Wound-Site Infection in Children with Myelomeningocele

Predictors of fistula formation after primary palatoplasty

Background: The goal of cleft palate repair is to create a seal between the oral and nasal cavities while improving speech by creating a functional velum. Various surgical techniques are at the surgeon's disposal to achieve this. Unfortunately, this sometimes fails, leading to formation of oronasal fistula. Objective: This study aimed to determine the predictors of oronasal fistula (ONF) formation following primary cleft palate repair. Methodology: This prospective interventional study involved cleft palate patients recruited from the University of Port Harcourt Teaching Hospital. Basic demographics and clinical data of participants were recorded preoperatively while morphometric measurements were taken under general anaesthesia to determine Cleft Palate Index and Cleft width. Four surgeons performed the procedures, and three surgical techniques were employed. Participants were followed up for a mean period of 5 months. The occurrence, location, and fate of ONF were documented. Correlation between ONF and potential predictor variables was tested, and determinant(s) of fistula formation was explored. Data was analysed using IBM SPSS version 21.0 with statistical significance set at P &lt; 0.05. Result: Eighty-two participants with ages ranging from 9 months to 19 years completed the study. The initial incidence of ONF was 29.3% but 16.7% of these cases resolved spontaneously within 5 weeks. Cleft Palate Index, Cleft width, and time (age) of repair significantly correlated with occurrence of ONF. However, Cleft width was the only statistically significant (p = 0.049) individual determinant of fistula formation. Conclusion: In this study, Cleft width W is the most important predictor of ONF formation.