0000000001285589

AUTHOR

Bianca Cudia

Effect of Fibrin Sealant on Seroma Formation Post-Incisional Hernia Repair

Background: Development of seroma after incisional hernia repair is a common complication. Our study aims to compare the outcomes of sublay incisional hernia repairs with or without spray instillation of fibrin glue. Methods: We enrolled fifty patients undergoing incisional hernia repair. In all patients a suction drain was placed in the subcutaneous space. In one group (FG) 4 ml fibrin glue was instilled in the subcutaneous space. In the control group (C) patients did not receive any prevention measure. Wounds fluids were collected on post-operative day 1 (POD) and once daily until drain removal. All patients were followed up by ultrasound on POD 15, 20, 40, 60. Results: Drain fluid produc…

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Nanofibrillar scaffold resists to bile and urine action: experiences in pigs

Biomaterial-based-scaffolds’ functions are to replace anatomical and functional features loss of an injured tissue. They can replace native tissue after their reabsorption. Material and methods. In our experimental procedures we utilized the PHEA-PLA+PCL scaffold in 2 female pigs to assess its resistance to bile and urine. Results. Both pigs survived to surgical procedures. After a month fibres appeared unchanged in term of form and dimension at electronic microscopy. Cells and ECM factors were founded inside the scaffold in a microscopical evaluation. Conclusion. Planar and tubular scaffolds were colonized by cells and extracellular matrix elements. The study conducted on pig suggested tha…

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Lymphatic Mesenteric Cyst, a Rare Cause of Surgical Abdominal Pain: Case Report and Review of the Literature

A lymphatic mesenteric cyst (LMC) is a rare clinical entity, of unclear etiopathogenesis, which can arise in the abdominal cavity or retroperitoneum without a clear origin. We describe a case of a 74-year-old male presenting with abdominal pain that was non-specific and non-responsive to medical therapy. Laboratory tests clinical examination were inconclusive while the abdominal computed tomography (CT) scan showed a cystic lesion of the ileal mesentery. We performed an open surgical excision of the lesion with the resolution of clinical symptoms. The lesion resulted to be an LMC at the histological examination. At the five-year CT scan follow-up, we did not record any recurrences. LMCs pre…

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Sequential and combined treatment of prolidase deficiency leg ulcers

Background The Authors report a case of chronic cutaneous lesions in a patient affected by prolidase deficiency, a rare disorder inherited through an autosomal recessive gene (50 cases reported ). The enzyme prolidase is widely distributed throughout the body and it is important in the recycling of proline and hydroxyproline. Among the clinical presentations, the most striking manifestation is the skin fragility with leg ulceration (see Table ​Table11) Table 1 Clinical signs of prolidase deficiency The deficiency of the enzyme prolidase is responsible for massive loss of proline in the urine which is estimated to be as high as 3 g/die. The diagnosis is ascertained by iminopeptiduria greater…

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Role of a medication in polyurethane foam in the treatment of diabetic foot lesions

Background The treatment of diabetic foot lesions need medications capable of managing wound infection and exudates that, variously combined, can influence the natural history of the pathology and therefore limb survival. A particular and economic device, is represented by honeycomb structure polyurethane foam Ligasano ©.

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Simultaneous Hybrid Treatment of Multilevel Peripheral Arterial Disease in Patients with Chronic Limb-Threatening Ischemia

Background: Hybrid treatments (HT) aim to reduce conventional open surgery invasiveness and address multilevel peripheral arterial disease (PAD). Herein, the simultaneous HT treatment in patients with chronic limb-threatening ischemia (CLTI) is reported. Methods: Retrospective analysis, for the period from May 2012 to April 2018, of patients presenting multilevel PAD with CLTI addressed with simultaneous HT. The outcomes of these interventions were measured the following metrics: early technical successes (within 30 days following treatment) and late technical successes (30 days or more following treatment) and included mortality, morbidity symptoms recurrence, and amputation. Survival and …

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Prognostic value of PCR, IL-6 and IL-10 serum levels in determining postoperative complications after geriatric surgery in diabetic patients

Background The onset of postoperative septic complications has been associated to serum levels of interleukin (IL) IL-6 and IL-10. [1,2]. We have extrapolated a diabetic group from a previous study to evaluate pre and postoperative profiles of some inflammatory markers (IL-6 , IL-10 and CRP). We related the data obtained to the onset of postoperative complications. Diabetic patients have been selected because of their high rate of post-operative complications, especially surgical wound infection.

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Predictive value of IL-6 and IL-10 serum levels in anastomotic leakage in elderly patients undergoing surgery for colorectal cancer

Methods The study group is yet represented by 33 patients: 17 males and 16 females (median age 76, range 70–89). The location of cancer was respectively: 5 (15, 15%) in the rectum, 15 (45, 45%) in the left colon, 11 (33, 33%) in the right colon, 1 (3, 3%) in the transverse colon, 1 (3, 3%) synchronous in the caecum and the sigmoid colon. The associated diseases observed were: chronic obstructive pulmonary disease, hypertension, diabetes mellitus, ischemic heart disease arterial vasculopathy.

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Stump appendicitis. A case report

Highlights • Stump appendicitis (SA) is a rare, but noteworthy, diagnosis that warrants early detection. • Delay in the diagnosis of SA may result in serious complications like stump gangrene, perforation and peritonitis. • More research is needed to identify strategies to prevent SA. • We underline the emergent role of lower endoscopy to clarify diagnosis resolve the symptoms. • Surgeons need to have a heightened awareness of the possibility of SA.

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Internal sphincterotomy reduces postoperative pain after Milligan Morgan haemorrhoidectomy

Abstract Background Over the last few years, there has been increasing attention on surgical procedures to treat haemorrhoids. The Milligan-Morgan haemorrhoidectomy is still one of the most popular surgical treatments of haemorrhoids. The aim of the present work is to assess postoperative pain, together with other early and late complications, after Milligan-Morgan haemorrhoidectomy as we could observe in our experience before and after performing an internal sphincterotomy. Methods from January 1980 to May 2007, we operated 850 patients, but only 699 patients (median age 53) were included in the present study because they satisfied our inclusion criteria. The patients were divided into two…

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Contribution of Large Genomic Rearrangements in Italian Lynch Syndrome Patients: Characterization of a Novel Alu-Mediated Deletion

Lynch syndrome is associated with germ-line mutations in the DNA mismatch repair (MMR) genes, mainlyMLH1andMSH2. Most of the mutations reported in these genes to date are point mutations, small deletions, and insertions. Large genomic rearrangements in the MMR genes predisposing to Lynch syndrome also occur, but the frequency varies depending on the population studied on average from 5 to 20%. The aim of this study was to examine the contribution of large rearrangements in theMLH1andMSH2genes in a well-characterised series of 63 unrelated Southern Italian Lynch syndrome patients who were negative for pathogenic point mutations in theMLH1,MSH2, andMSH6genes. We identified a large novel delet…

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Prognostic value of IL-6 and IL-10 serum levels and immunonutritional assessment in determining postoperative complications after geriatric surgery

The onset of postoperative septic complications has recently been associated to serum levels of interleukin (IL) IL-6 and IL-10. Patients with complications have higher serum levels than patients without complication after surgery. IL-6 has been recognized as early marker of postoperative septic events. Furthermore IL-6 increases with age, expecially if there are associated diseases. It is a sign of functional deterioration of different organs. The disregulation in interleukin production, anesthetic drugs, hemorrhage and transfusions may lead to the onset of postoperative complications. The latter are more frequent in oncologic patients. The aim of our study is to evaluate pre- and postoper…

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Conservative Treatment of Splenic Haematoma After Colonoscopy: A Case Report

Colonoscopy is a routine procedure performed worldwide, nevertheless, a small risk of splenic injury, often under-estimated, is still present. As a matter of fact, the diagnosis may be delayed, leading to a rising risk of morbidity and mortality. This paper describes a case of conservative treatment of colonoscopy-associated splenic injury. A 57-year-old woman presented with worsening pain in the upper left abdominal quadrant; she had radiation therapy to the ipsilateral subscapular region, and a diagnostic colonoscopy 18 hours earlier. The computed tomography (CT) scan revealed splenic laceration without signs of hemoperitoneum. Because of the hemodynamic stability of the patient, successf…

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Early diagnosis of primary melanoma of caecum. Case report and review of the literature.

Malignant gastrointestinal melanoma is usually a metastatic lesion. We report the case of a 79-year-old female asymptomatic patient. Colonoscopy revealed one plane 15 mm pigmented lesion in the caecum. Neither CT scan of the abdomen nor right hemicolectomy revealed no metastatic disease. Histopathological examination of the surgical specimen was indicative of malignant melanoma.A set of additional enquires such as laboratory and imaging tests did not point out any suspicious lesions in the skin, eye, leptomeninges or other sites. Therefore, we made the diagnosis of primary colonic melanoma.The diagnosis of this disease is still a challange and often demanding for a multidisciplinary approac…

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