Type Of Drainage Research Articles

Classical pressure profile prediction using a hybrid form of artificial neural network algorithm applied to building drainage systems

Classical pressure profile data for building drainage systems (BDS) represent a temporal snapshot of the pressure regime within the system following an event such as a water discharge from an appliance, and therefore can be an indicator of system performance. This research describes, for the first time, a method of predicting the pressure profile using FF(Feed Forward -PSO(Particle Swarm Optimization) artificial neural network (ANN) algorithm. The ANN model was validated against two sets of data: the first from a dedicated 32-storey building drainage experimental test rig at the National Lift Tower (NLT) test facility in Northampton, UK, and the second set of data from a validated numerical model, AIRNET. Both data sets were used to assess the FF- PSO-ANN Model. Calculation errors were minimized by refining weight vectors with a PSO scheme. The convergence of the PSO algorithm was managed through adjusted inertia weights, population size, damping factor, and acceleration coefficients. A generic prediction model was developed using a database of similar building drainage types and configurations. This algorithm refines and trains the ANN model, enhancing its applicability across various applications. The study confirms that the FF-PSO ANN model effectively predicts BDS pressure profile data and system performance. Practical application The ANN model presented develops a new approach with which to assess performance of a BDS at design stage. The model is based on the philosophy of a natural search algorithm which helps to attain global optimisation by refining the weight vectors. It is envisaged that this model can form a part of the assessment of designs at an early stage and provide useful information on the performance of the system. The in-built learning of the model allows accuracy to be improved as the database of existing pressure profiles increases, thus making the tool more relevant with time.

Risk factors for recurrenсe of hydronephrosis in children

Introduction. Relapse after radical correction of congenital hydronephrosis (CH) in children occurs in 5–11% of cases. However, the predictors of repeated obstruction of the pyeloureteral segment (PUS) have not yet been sufficiently evaluated, which determines the relevance of the topic. Aim: to detect the risk factors for recurrence of hydronephrosis in children to develop methods for its prevention. Materials and methods. There were examined one hundred children with hydronephrosis divided into 2 groups. Group 1 consisted of 50 patients with recurrent hydronephrosis (RH), group 2 (control) — 50 children without RH with a comparable functional condition of the affected kidney. The analysis of the influence of pre-, intra- and postoperative parameters on the outcome of the primary intervention was carried out. Results. During primary intervention in CH patients from group 1, we identified the following significant differences compared with patients of group 2: the use of non-resection pyeloplasty; a more extended stricture of the PUS; an indentation of less than 5 mm from the edge of stenosis; tension of the edges of the anastomosis due to insufficient mobilization; acute pyelonephritis during the early postoperative period. When the anastomosis tissues were stretched, only one type of urine drainage (internal or external) was performed in patients from group 1, and combined drainage was provided in patients of group 2. Conclusion. To prevent recurrence of hydronephrosis in children, it is necessary to perform exclusively resection ureteropyeloplasty with adequate tissue mobilization and a wide margin from the edge of stenosis, use combined drainage when stretching the edges of the anastomosis and ensure the observation of operated children before moving to the adult network.

Enhanced Recovery After Surgery for patients undergoing radical cystectomy: Surgeons' perspectives and recommendations ten years after its implementation.

Enhanced Recovery After Surgery (ERAS) guidelines for Radical Cystectomy (RC) were published over ten years ago. Aim of this systematic review is to update ERAS recommendations for patients undergoing RC and to give an expert opinion on the relevance of each single ERAS item. A systematic review was performed to identify the impact of each single ERAS item on RC outcomes. Embase and Medline (through Pubmed) were searched systematically. Relevant articles were selected and graded. For each ERAS item, a level of evidence was determined. An e-Delphi consensus was then performed amongst an international panel with renowned experience in RC to provide recommendations based on expert opinion. Preoperative medical optimization and avoiding bowel preparation are highly recommended. Robotic-assisted RC with intracorporeal urinary diversion is moderately recommended and can help in applying other ERAS items, such as early mobilization. Medical thromboprophylaxis should be administered and nasogastric tube should be removed at the end of surgery. Perioperative fluid restriction as well as opioid-sparing anesthesia protocols should be implemented. Generally, consensus was reached on most ERAS items, with the exception of epidural anesthesia (no consensus), resection site drainage (consensus against), and type of urinary drainage. Limitations include the lack of a multidisciplinary approach to the present consensus, giving however a highly specialized surgical opinion on ERAS. and clinical implications: The current study updates ERAS recommendations for patients undergoing RC and suggests application of ERAS by a panel of experts in the field.

Efficacy and Safety of Two Different Approaches in the Drainage of the Upper Urinary Tract in "Acute Obstructive Uropathy": A Critical Evaluation.

Aim: To compare the results of retrograde ureteral stent (RUS) and percutaneous nephrostomy (PCN) procedures for decompression in patients with acute obstructive pyelonephritis. Patients and Methods: Medical records of patients undergoing PCN or RUS for emergency urinary diversion because of obstructive pyelonephritis were evaluated retrospectively. Patients with urinary tract obstruction and concurrent fever (≥38°C), pyuria, and costovertebral angle tenderness were included and divided into two groups based on the type of emergency urinary drainage applied (PCN in Group 1) and (RUS in Group 2). Apart from the demographic data and Charlson Comorbidity Index, laboratory and radiologic examination outcomes were well evaluated. Results: A total of 155 patients including 73 patients (47.1%) undergoing PCN (Group 1) and 82 patients (52.9%) undergoing RUS (Group 2). Although no significant difference was found regarding the demographic characteristics, the operation time, as well as fluoroscopy time, was significantly shorter in Group 1 cases when compared with those in Group 2 (p < 0.0001). The success rate was similar between the two groups, and there was also a significant difference regarding the complication rates in both groups of cases (5.5% vs 7.3%). Conclusions: Our findings showed that despite similar efficacy and success rates noted between PCN and RUS applications in the emergency drainage of cases presenting with obstructive pyelonephritis, PCN application was found to be advantageous because of shorter operation and fluoroscopy durations. More importantly, this approach was associated with a significantly less need for intensive care during the postoperative period.

Prophylactic intra-abdominal drainage during pancreaticoduodenectomy: A systematic review and meta-analysis

Background: Prophylactic abdominal drainage during pancreaticoduodenectomy (PD) is a common treatment strategy for pancreatic fistula. However, its benefits and safety have been the subject of debate. The objective of this meta-analysis and system review is to assess the effects of prophylactic drainage, various types of drainage (active and passive), and the timing of drainage removal (early and late) on the postoperative outcomes of PD. Methods: A systematic literature search was conducted in the PubMed, Web of Science, and Cochrane Library databases as of April 28, 2024. Randomized controlled trials (RCTs) comparing prophylactic abdominal drainage, different drainage patterns, and the timing of drainage removal after PD were included, and the postoperative outcomes were evaluated. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated to aggregate dichotomous outcomes. Meta-analysis was performed using the Mantel-Haenszel fixed- and random-effects models. Results: Nine RCTs, including a total of 1638 patients, were incorporated in our study. The meta-analysis showed no statistically significant differences in postoperative outcomes between the closed-suction drain (CSD) group and the passive drain to gravity (PDG) group. Compared to the late drain removal (LDR) group, the early drain removal (EDR) group had a significant reduction in the incidence of Clinically relevant postoperative pancreatic fistula (CR-POPF) (OR=0.39, 95% CI=0.20 to 0.79; P=0.009), morbidity (OR=0.41, 95% CI=0.20 to 0.84; P=0.01) and intra-abdominal infection (OR=0.40, 95% CI=0.22 to 0.75; P=0.004). For the group of present of drainage and the group of absent of drainage, the patient inclusion criteria of the included studies were too heterogeneous, making meta-analysis inappropriate. Conclusion: The existing evidence is insufficient to negate the necessity of prophylactic drainage after PD. The meta-analysis did not show superiority of any specific approaches of drainage tube. But this review did indicate that patients benefit from EDR in terms of CR-POPF, morbidity and intra-abdominal infection. EDR was recommended for low/intermediate risk patients.

Examining geographic variation in the prevalence of household drainage types across India in 2019-2021

The proportion of Indian households with access to a toilet has grown considerably over the past decade. Many of these toilets rely on on-site containment, either in the form of a septic tank or soak pit. If the waste from these containers is not removed using some type of mechanized method, it can overflow into drains before flowing into treatment facilities or being discharged into water bodies. Therefore, drains are a critical part of the sanitation chain. What remains unknown, however, is what types of drains are available to households in India. Understanding this is critical given that people are at a greater risk of ingesting contaminated water and making dermal contact with pathogens if waste flows in open drains. For the first time, India’s National Family Health Survey from 2019–2021 contains data on the type of drainage available to households. Thus, the purpose of this paper is to estimate the prevalence of households relying on no drainage, open drainage, drains to soak pits, and closed drainage. We also estimate these prevalence values for each of India’s 720 districts and by urban/rural communities to understand the geographic clustering of drainage types throughout India. Overall, we found that the most common drainage type was open drains (37.5% | 95% CI: 37.3–37.6), followed by closed drains (33.9% | 95% CI: 33.7–34.0). The household prevalence of open drainage was above 42% in more than half of India’s 720 districts. Similarly, the household prevalence of closed drainage was below 24% in more than half of India’s 720 districts. We also found that open drains were more common in rural communities, while closed drains were more common in urban communities. We also found a socioeconomic gradient in terms of drainage types, with those lower on the socioeconomic spectrum more likely to have open drains or no drainage. Our results underscore the need to both geographically and socioeconomically target interventions that ensure households have access to adequate drainage. Doing so is vital to remove contamination from the environment as a means of preventing morbidity.

Does Routine Post-Operative Use of Drainage in Minimally Invasive Lumbar Spine Surgery Offer Better Results?

Objective: The advantages of minimally invasive spine surgery (MISS) in lumbar degenerative diseases have been well described (less tissue damage, shorter hospital stay, better results in pain assessment). One aspect that has not yet been studied enough is the usage of a post-operative drain in MISS. The aim of this study was to determine whether drainage in MISS is necessary or not and what advantages or disadvantages its use offers. Materials - Methods: We conducted a systematic review of the published literature, searching articles published on Pubmed and Embasse until December 1st 2022, regarding MISS in the lumbar region and post-operative drain usage. Our inclusion criteria were original articles written in English and articles using minimally invasive techniques (usage of tubular retractors along with an endoscope or microscope, paramedian incision, percutaneous screw placement). 42 articles were assessed, and after careful examination and duplication exclusion, 26 research papers were included. Usage, type and duration of postoperative drainage, length of hospital stay, ambulation time and complications were extracted, and relevant results were pooled. Results: The majority of the included articles (80.7 %) reported using a negative-pressure post-operative drain tube. Drains were removed either 48 hours after surgery or when the drainage volume was less than 50ml/24h. Hospital stays and time to ambulation were shorter in cases where drainage was not used. There was no difference in complications between cases where drainage was used and those that it was not. Conclusion: The rationale behind post-operative drainage in MISS is to protect from surgical site infections and hematoma creation. Based on our study there is no evidence to support this hypothesis. On the contrary, our results suggest that the drawbacks of using a drain (pain, discomfort, anxiety, inconvenience of mobilisation, prolongation of hospitalisation) outweigh the advantages, thus making the routine use of postoperative drainage in MISS unnecessary.

Updating the paradigm of prophylactic abdominal drainage following Pancreatoduodenectomy (review article).

Prophylactic abdominal drainage (PAD) is considered a routine procedure after pancreatoduodenectomy (PD) to prevent and detect severe complications at an early stage. However, the drainage itself may cause adverse consequences. Thus, the optimal strategy of PAD after PD remains controversial. The present paper summarizes the latest research on the strategies of PAD following PD, mainly focusing on 1) the selective placement of PAD, 2) the optimal drainage types, 3) the early removal of drainage (EDR), and 4) novel strategies for PAD management. Accurate stratifications based on the potential risk factors of clinically relevant-postoperative pancreatic fistula (CR-POPF) facilitates the selective placement of PAD and the implementation of EDR, with postoperative outcomes superior or similar to routine PAD placement. Both active and passive drainage methods are feasible in most patients after PD, with similar prognostic outcomes. Novel predictive models with accurate, dynamic, and individualized performance further guide the management of PAD and afford a better prognosis. Evidence-based risk stratification of CR-POPF aids in the management of PAD in patients undergoing PD. Novel dynamic and individualized PAD strategies might be the next hotspot in drain-relevant explorations.

Comparison between the use of subdural and subgaleal drainage in treatment of chronic subdural hematoma

Background and objectivesChronic subdural hematoma (CSDH) is one of the most common pathologies in our daily practice. The standard treatment is the evacuation making a burr-hole and placement of a subdural drainage, which has shown to decrease its recurrence. However, this procedure can entail risks such as parenchymal damage, infection, or the onset of seizures, prompting the consideration of subgaleal drainage as an alternative.Our objective is to compare the use of subdural and subgaleal drainage in a cohort of patients undergoing intervention for CSDH, as well as to analyze the differences in complication rates and recurrence between the two groups. MethodologyA retrospective analytical observational study was conducted, analyzing 152 patients diagnosed with CSDH who underwent intervention at our center from January 2020 to April 2022. Patients in whom drainage was not placed were excluded. In all patients, a burr-hole was performed and the type of drainage was chosen by the neurosurgeon. ResultsOut of the 152 patients, subdural drainage was placed in 80 cases (52.63%), while subgaleal drainage was used in 72 cases (47.37%). There were no significant differences in the recurrence rate (30% in the subdural drainage group vs. 20.83% in the subgaleal drainage group; P = .134) or in the complication rate (7.5% in the subdural drainage group vs. 5.5% in the subgaleal drainage group; P = .749). ConclusionsSubgaleal drainage shows similar clinical outcomes with a recurrence and complication rate comparable to subdural drainage, suggesting it as a safe and effective alternative to subdural drainage in the treatment of CSDH.

Suprapubic versus transurethral catheterization for bladder drainage in male rectal cancer surgery (GRECCAR10), a randomized clinical trial.

Bladder drainage is systematically used in rectal cancer surgery; however, the optimal type of drainage, transurethral catheterization (TUC) or suprapubic catheterization (SPC), is still controversial. The aim was to compare the rates of urinary tract infection on the fourth postoperative day (POD4) between TUC and SPC, after rectal cancer surgery regardless of the day of removal of the urinary drain. This randomized clinical trial in 19 expert colorectal surgery centers in France and Belgium was performed between October 2016 and October 2019 and included 240 men (with normal or subnormal voiding function) undergoing mesorectal excision with low anastomosis for rectal cancer. Patients were followed at postoperative days4, 30, and 180. In 208 patients (median age 66years [IQR 58-71]) randomized to TUC (n = 99) or SPC (n = 109), the rate of urinary infection at POD4 was not significantly different whatever the type of drainage (11/99 (11.1%) vs. 8/109 (7.3%), 95%CI, - 4.2% to 11.7%; p = 0.35). There was significantly more pyuria in the TUC group (79/99 (79.0%) vs. (60/109 (60.9%), 95%CI, 5.7-30.0%; p = 0.004). No difference in bacteriuria was observed between the groups. Patients in the TUC group had a shorter duration of catheterization (median 4 [2-5] vs. 4 [3-5] days; p = 0.002). Drainage complications were more frequent in the SPC group at all followup visits. TUC should be preferred over SPC in male patients undergoing surgery for mid and/or lower rectal cancers, owing to the lower rate of complications and shorter duration of catheterization. ClinicalTrials.gov identifier NCT02922647.

Comparación entre el uso de drenaje subdural y subgaleal en tratamiento del hematoma subdural crónico

Background and objetivesChronic subdural hematoma (CSDH) is one of the most common pathologies in our daily practice. The standard treatment is the evacuation making a burr-hole and placement of a subdural drainage, which has shown to decrease its recurrence. However, this procedure can entail risks such as parenchymal damage, infection, or the onset of seizures, prompting the consideration of subgaleal drainage as an alternative.Our objective is to compare the use of subdural and subgaleal drainage in a cohort of patients undergoing intervention for CSDH, as well as to analyze the differences in complication rates and recurrence between the two groups. MethodologyA retrospective analytical observational study was conducted, analyzing 152 patients diagnosed with CSDH who underwent intervention at our center from January 2020 to April 2022. Patients in whom drainage was not placed were excluded. In all patients, a burr-hole was performed and the type of drainage was chosen by the neurosurgeon. ResultsOut of the 152 patients, subdural drainage was placed in 80 cases (52.63%), while subgaleal drainage was used in 72 cases (47.37%). There were no significant differences in the recurrence rate (30% in the subdural drainage group vs. 20.83% in the subgaleal drainage group; P=.134) or in the complication rate (7.5% in the subdural drainage group vs. 5.5% in the subgaleal drainage group; P=.749). ConclusionsSubgaleal drainage shows similar clinical outcomes with a recurrence and complication rate comparable to subdural drainage, suggesting it as a safe and effective alternative to subdural drainage in the treatment of CSDH.

Step-by-step venous navigation in treatment of tentorial dural arteriovenous fistula supplied by artery of Bernasconi and Cassinari.

The artery of Bernasconi and Cassinari is a small infraclinoid branch of the internal carotid artery that originates from its cavernous segment and then runs along the tentorium. Because of its gracile appearance, it is often visible only when related to neoplasms and vascular lesions in the tentorial regions.1 Dural arteriovenous fistulas (dAVFs) are arteriovenous shunts contained within the dural leaflets, supplied largely by the regional meningeal arteries and classified based on the type of venous drainage. Tentorial dAVFs are mostly supplied by branches of the meningohypophyseal trunk, including the artery of Bernasconi and Cassinari.2 Unlike fistulas of other locations, tentorial fistulas are linked with a higher risk for venous hypertension and hemorrhage and thus demand immediate and appropriate treatment.3 Digital subtraction angiography is necessary to understand its arterial and venous components. Treatment aims to achieve complete embolization of the fistulous connection and venous portions by either a transarterial or transvenous approach, without causing serious changes in the flow dynamics.4, 5.

Location-based clinical and angiographic profile of brain arteriovenous malformations - a single-center observational study.

The location of brain arteriovenous malformations (bAVM) is one of the most relevant prognostic factors included in surgical, endovascular and radiosurgical scores. However, their characteristics according to location are seldom described. The goal of this study was to describe the clinical and angiographic characteristics of bAVM classified according to their location. This retrospective observational study included patients diagnosed with bAVM and attending a national referral hospital during the period 2010-2020. Data regarding clinical and angiographic variables were extracted, including characteristics on nidus, arterial afferents, venous drainage and associated aneurysms. BAVM were classified in 8 groups according to their location: frontal, temporal, parieto-occipital, periventricular, deep, cerebellar, brainstem and mixed. Data distribution for each group was determined and between-group differences were assessed. A total of 269 bAVM (in 258 patients) were included. The most frequent location was parieto-occipital; and the least frequent, brainstem. Statistically significant differences were observed between groups for most studied variables, including: clinical presentation, functional status at admission; nidus size and density, classification according to the Spetzler-Martin, Buffalo and modified Pollock-Flickinger scales; number, diameter, origin and type of afferents; number, diameter, type and direction of venous drainage, retrograde venous flow; and presence and size of flow-related aneurysms. The clinical and angiographic differences observed between brain AVM groups allow the formulation of profiles according to their location.

Dynamics of humus in field crop rotations on drained lands

The purpose of the research is to study the influence of different types of field crop rotation, fertilizers, drainage and hydrothermal conditions on the dynamics of humus in reclaimed soil. The studies were carried out on the experimental fields of the All-Russian Research Institute of Reclaimed Lands (reclamation sites “Kuzminskoye Boloto 2”, “Semenovskoye” and “Gubino” in the Tver region). Waterlogged soils were drained using closed drainage (inter-drain distance is 18–20 m, drain depth is 0.9–1.2 m). The soils of the experimental plots are soddy-podzolic, light loamy, gleyic, formed on a moraine or thin binomial. Observations of the dynamics of humus were carried out in the grain-grass-row, grain-grass, grain and grain-row types of crop rotation. The influence of crop rotation on the content of humus in the soil was determined, first of all, by the composition, the structure of the crops grown and agricultural technology of their cultivation. Due to plant residues, 56.6–76.5 % of the volume of mineralized humus were restored in grain-grass-row crop rotation, 51.8 % in grain, 26.4 % in grain-row crop rotation. The most significant qualitative changes in the composition of humus were observed in grain-grass-row crop rotation: with a positive humus balance, the ratio of humic and fulvic acids increased from 0.63 to 0.74. The use of organic and mineral fertilizers significantly changes the balance of humus in the arable layer of the soil. With an organic-mineral fertilizer system, the annual loss of humus (in kg/ha) on the drained plot was 6.8–11.4 times less, on the non-drained plot – 2.1–2.6 times less than in the variant without fertilizers. Drainage of waterlogged soils increases the role of fertilizers in the accumulation of humus, reduces its losses and improves the quality parameters of humus – the ratio of humic and fulvic acids in the composition of humus under the influence of drainage increased from 0.61 to 0.88. The impact on the dynamics of humus of hydrothermal conditions has been established. In years with a dry first half of the growing season, an increase in humus content is observed; in excessively wet years, on the contrary, a decrease is observed. The correlation coefficients of humus content with hydrothermal conditions in May-June were – 0.84 (in 1985–1993) and 0.95 (in 2014–2022).

Pollutant accumulation and microbial community evolution in rain gardens with different drainage types at field scale

Rain gardens play a key role in urban non-point source pollution control. The drainage type affects the infiltration processes of runoff pollutants. The soil properties and microbial community structures were studied to reveal the stability of the ecosystem in rain gardens with different drainage types under long-term operation. The results showed that the soil water content and total organic carbon in the drained rain gardens were always higher than that of the infiltrated ones. With the increase in running time, the contents of heavy metals in rain gardens showed significant accumulation phenomena, especially the contents of Zn and Pb in drained rain gardens were higher than that in infiltrated ones. The accumulation of pollutants resulted in lower microbial diversity in drained rain gardens than in infiltrated rain gardens, but the microbial community structures were the same in all rain gardens. The effects of drainage type on microbial community evolution were not significant, only the accumulation of heavy metals led to changes in the abundance of dominant microorganisms. There were differences in the soil environment of rain gardens with different drainage types. The long-term operation of rain gardens led to fluctuations in the soil ecosystem, while the internal micro-ecosystems of the drained rain gardens were in unstable states.

Evaluation of the effectiveness of different types of drainage on mineral heavy loamy soils: parameters, modes, the need for reconstruction of drainage systems

Influence of plastic trenchless and pottery trench drainage on physical and chemical properties of mineral ogleyed soils formed on carbonate-free loess-like loams with medium and low water permeability (Kf 0.1–0.3 m∙day-1) is estimated. The peculiarities of water regime of gray forest gleied soils of different degree of gleying in years of different moisture content were revealed. In profile of gleyed soils in spring and fall two-tiered top-water is formed that causes decrease of crop yield or their death. Drainage has been shown to eliminate topsoil water. Pottery trench and plastic trenchless drainage have close agroecological and hydrological influence on the considered soils. Transformation of physical and chemical properties as well as humus state of soils drained by different types of drainage has been established. Long-term studies of plastic and pottery drainage aft ereffects allow to study evolution of drained soils and adjacent landscape. On the basis of 30-year study of heavy loamy soils and ferromanganese nodules it is proposed for the first time to use the parameter «carbon content in Fe-Mn ortsteins»: firstly, for diagnostics of soil hydromorphism degree; secondly, for evaluation of drainage systems efficiency and expediency of their reconstruction.

Silvicultural Practices and Water Table Dynamics of Coastal Forested Wetlands

HighlightsForested wetland hydrology (WH) is characterized by changes in daily water table (WT) depth over time.Silvicultural operations (harvesting, thinning, bedding, and minor drainage and intensity) affect WT dynamics.Both WT dynamics and WH are also affected by tree stand age/growth and soil types, besides the climate.Knowledge gaps and future research using modeling, including machine learning methods are discussed.Abstract. Sustainable management of forested wetlands requires an understanding of water table (WT) dynamics affected by rainfall and evapotranspiration (ET) as well as management practices to sustain water quality, quantity, and ecosystem services. The hydrology, the most important factor influencing productivity of forested wetlands, may be characterized by measuring changes in WT depth over time. The hydrology of U.S. Southeastern Coastal Plain forested wetlands, particularly wet pine flats and pocosins, where drainage has been commonly used to improve tree growth, is relatively well understood. However, uncertainties remain regarding the effects of some silvicultural practices on WT dynamics of varying soil and drainage types and the role of climatic trends, including extreme events (precipitation and droughts), on WT dynamics of these forested lands. In this paper, we use information from long-term monitoring and modeling studies conducted at sites in the Southeastern Atlantic Coastal Plain to review the current state of research on potential effects of harvesting, thinning, bedding, and minor drainage on changes to WT dynamics in coastal non-riverine forested wetlands. We also briefly illustrate current gaps in knowledge and outline future potential research in this area. Keywords: Pine forest, Bedding, Harvesting, Minor drainage, Water table, Wetland hydrology, Hydrology models.

Infectious complications after elective surgeries on the liver and pancreas

Aim. To analyze the complications of liver and pancreas surgeries, including infectious complications, and to describe the evolution of microbial flora in the hepatopancreatobiliary surgery unit.Materials and methods. The study involved 650 patients who underwent pancreatoduodenectomy and 1253 patients after liver resection. Types of preoperative biliary drainage were evaluated in terms of their influence on the treatment results. The incidence and nature of postoperative bile leakage were studied. The study included an analysis of microbial flora in the hepatopancreatobiliary surgery unit for 10 years.Results. The rate of significant complications, including infectious complications, appeared to be unaffected by a type of bile ducts drainage with potential infection at a standard course after pancreatoduodenectomy. A pancreatic fistula is considered to be a major factor in the development of abdominal infectious complications and the main cause of unfavorable outcomes. A bile leakage was most often revealed after liver resection in 95 observations (7.5%), and significantly more often after extensive liver resections. Gram-negative flora prevailed in bile from external drains of bile ducts and wound exudates in two thirds of cases. Gram-positive microorganisms were detected in one third of patients, fungi – in less than 5% of cases. The drainage fluids mostly obtained polyresistant gram-negative microorganisms. The majority of strains revealed resistance to cephalosporins, fluoroquinolones, penicillins, and an increasing resistance to carbapenems in dynamics.Conclusion. Bacterobilia after bile duct drainage significantly determines a microbial landscape of a hepatopancreatobiliary surgery unit. Pancreatodigestive anastomotic leakage is recognized as an important predictor of infectious complications in the area of intervention after pancreatoduodenectomy. Cases of this kind require the antimicrobial therapy with respect to the initial flora of the biliary tract. A bile leakage is considered to be a main contributor to infectious complications after liver resection. Extensive liver resection can lead to a sepsis-like state in the early postoperative period, predisposing to infectious complications.

Nosological concept and classification of venogenous erectile dysfunction

Various forms of proximal and distal types of pathological venous drainage from the cavernous bodies in patients with venogenic erectile dysfunction were studied and described using 3D computed cavernosography. The operation of targeted ligation of the veins of the penis based on the results of 3D computed cavernosography was developed and put into practice. A nosological concept and classification of venogenic erectile dysfunction (kind – type – form) has been developed and proposed.

Antibiotic prophylaxis and surgical site infections in orthognathic surgery – a retrospective analysis

BackgroundThis study was conducted to determine surgical site infection (SSI) rates and potential risk factors as well as to evaluate antibiotic prophylaxis in orthognathic surgery.MethodsThis retrospective observational study included patients who received orthognathic surgery. SSIs and their management were assessed for up to one year post-operatively. The applied antibiotic regime and other possible influencing factors (smoking, age, site of infection, drainage, duration of surgery, displacement distances, craniofacial malformations) were assessed.ResultsIn total 291 patient met the inclusion criteria (56.7% female). The mean age at surgery was 25.5 ± 8.5 years. Fifty-four patients (18.6%) were diagnosed with a craniofacial malformation. Relevant previous surgeries were documented in about one quarter of included patients (n = 75). Ninety-two percent of patients (n = 267) received intraoperative single-dose antibiotic prophylaxis. Surgical site infections occurred in 12.4% (n = 36) of patients. There was a significant association between postoperative infections and type of surgery (P = .037) as well as type of drainage (P = .002). Statistical analyses also revealed a higher prevalence of smokers (P = .036) and previous surgically assisted rapid palatal expansion (SARPE) (P = .018) in the infection group. Furthermore, no significant relationships were observed between postoperative infections and various co-factors (i.e. antibiotic regime, age at surgery, gender, associated craniofacial malformations, surgery duration, displacement distances, mandibular setback vs. advancement).ConclusionLow rates of SSIs occurred following an intraoperative single-dose antibiotic regime. None of the SSIs had a significant effect on the final surgical outcome. Present data do not warrant escalation of the antibiotic regimen. Postoperative smoking and capillary drainage should be avoided.