Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, r…

Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assess…

Male breast cancer: Reconstructive surgery

The conventional treatment for male breast cancer consists of modified radical mastectomy with axillary sentinel node biopsy and/or axillary lymph node dissection in case of lymph node-positive disease. However, breast-conserving surgery (BCS) is gaining popularity also among men. In both cases, surgery leaves an aesthetic disfigurement that impacts patient well-being and quality of life. Thus, even if male breast has a different social and emotional role than female’s one, male breast reconstruction deserves the same importance. The aim of this chapter is to give a comprehensive review on latest indications and strategies for the post-oncological reconstructive surgery of the male breast.

Re: Correlation between tissue-harvesting method and donor-site with the yield of spheroids from adipose-derived stem cells

Correlation between tissue-harvesting method and donor-site with the yield of spheroids from adipose-derived stem cells

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…

κ-Carrageenan and PVA blends as bioinks to 3D print scaffolds for cartilage reconstruction.

3D printing of polymeric scaffolds and autologous stem cells is a promising tool for damaged facial cartilage reconstruction surgeries. To this end, suitable bioinks are needed to generate scaffolds with the required morphological and functional features. We formulated hydrogel bioinks using k-Carrageen (kC) and poly(vinyl alcohol) (PVA) in three different weight ratios. The kC gives the systems the ability to undergo rapid sol-to-gel transitions upon cooling from 60 °C and above to body temperature, while the PVA is used as rheology modifier and porogen. The latter is crosslinked after molding or printing by freeze-thaw cycling for 1 day (FT1) or 5 days (FT5). To select the most suitable f…

Spheroids of adipose derived stem cells show their potential in differentiating towards the angiogenic lineage

Introduction: Adipose derived stem cells (ASCs) are a mesenchymal stem cell population of great scientific interest due to their abundance and easiness in obtaining them from adipose tissue. Recently, several techniques for three dimensional (3D) ASCs cultivation have been developed to obtain spheroids of adipose stem cells (SASCs). It was already proved that ASCs are able to differentiate towards the endothelial lineage thus, for the first time, we investigated the ability of our 3D SASCs to differentiate endothelially and the effects of not differentiated SASC secreted factors on specific cultured cells. Materials and methods: SASCs were differentiated with a specific medium towards endot…

Chest fistula repair

Chest wall plays a fundamental role in the human body, as it represents a protective cage around vital organs such as heart and lungs. Chest wall fistula is a rare and insidious condition that could lead to severe functional and aesthetical consequences, and thus represents a serious surgical challenge. Goals of reconstructive surgery are to preserve the respiratory function, to provide visceral protection, and to assure the best possible cosmetic outcome. In this chapter, we present an overview of all key principles in chest wall fistula management and repair.