Perineal Wound Closure Using Biological Mesh Following Extralevator Abdominoperineal Excision

2018 ◽  
Vol 36 (4) ◽  
pp. 281-288 ◽  
Author(s):  
Naseer Baloch ◽  
Per J. Nilsson ◽  
Caroline Nordenvall ◽  
Mirna Abraham-Nordling
Keyword(s):  
Wound Closure ◽  
Perineal Wound ◽  
Abdominoperineal Excision ◽  
Biological Mesh ◽  
Single Centre ◽  
Short Term ◽  
Perineal Reconstruction ◽  
Primary Rectal Cancer ◽  
Different Types ◽  
Electronic Hospital

Aims: This study aimed to describe the short-term perineal healing rates in patients with perineal reconstruction using a biological mesh following extralevator abdominoperineal excision (elAPE). Methods: In a retrospective, descriptive single-centre cohort study, 88 consecutive patients treated with elAPE and perineal closure using a biological mesh between January 2011 and December 2015 were reviewed. All available data from electronic hospital records was collected. Patients were followed for 1 year following surgery and perineal wound status assessed at 3 months and at 1 year. Results: In total, 63 patients were male and all but 8 patients were treated for primary rectal cancer. All patients but 3 had received radiotherapy prior to surgery. Multivisceral excisions were performed in 19 patients. Omentoplasty was performed in 55 patients and 3 different types of meshes were used during the study period. At 3 months, 58 patients (66%) had a healed perineum. No association was detected between patient, tumour or perioperative characteristics and perineal wound status at 3 months. At 1 year, 4 patients were deceased and among the remaining 84, the perineal wound was healed in 77 patients (92%). Conclusion: The use of biological meshes in perineal reconstruction following elAPE is feasible and safe, and the perineal wound is healed in the majority of the patients within 3 months.

scholarly journals Outcomes following abdominoperineal resection 6 years retrospective study at a rural district general hospital

2021 ◽  
Vol 9 (3) ◽  
pp. 665
Author(s):  
Deeksha Arora ◽  
Michael Tang ◽  
Thomas Seddon ◽  
Milind Rao
Keyword(s):  
Retrospective Study ◽  
Wound Closure ◽  
Surgical Techniques ◽  
Perineal Wound ◽  
Biological Mesh ◽  
Wound Complications ◽  
Complication Rates ◽  
Patient Factors ◽  
Mesh Group ◽  
Significant Difference

Background: A range of surgical techniques are used for perineal wound closure following Abdominoperineal Excision of the Rectum (APER). The aim of this study was to assess the safety and effectiveness of using a biological mesh for perineal wound closure and to compare the outcomes following conventional suture and mesh closure of the perineal wound.Methods: A single-centre retrospective study of a cohort of patients undergoing surgery for low rectal cancer between January 2013 and December 2018. Patient records were analysed for outcomes including perineal complication rates, length of hospital stay and impact of patient factors on complication rates in mesh vs no mesh group.Results: Of the total 43 patients included in the study, 13 (30%) had a conventional perineal closure whereas 30 patients (70%) had a biological mesh reconstruction.  Early perineal wound complications were seen in 21/43 (49%) patients. Of those, 6 (29%) patients were in the no mesh group compared to 15 (71%) patients in the mesh group (p = 0.81). 84% of the patients who received neo adjuvant radiotherapy (NART) developed perineal wound infection. There was no statistically significant difference in the mesh and no mesh groups. None of the patient factors, other than preoperative anaemia, had a statistically significant association with the rate of complications in either of the groups.Conclusions: There was no statistically significant difference in the complication rate between primary and biological mesh closure. Biological mesh is safe for perineal reconstruction following APER.

Single centre experience of bilateral gracilis flap perineal reconstruction following extra‐levator abdominoperineal excision

2019 ◽  
Vol 21 (8) ◽  
pp. 910-916 ◽  
Author(s):  
J. A. J. Coelho ◽  
F. D. McDermott ◽  
O. Cameron ◽  
N. J. Smart ◽  
A. M. Watts ◽  
...  
Keyword(s):  
Abdominoperineal Excision ◽  
Single Centre ◽  
Perineal Reconstruction ◽  
Single Centre Experience

Comprehensive Effects of Short-Term Rental Platforms Across Hotel Types in U.S. and International Destinations

2021 ◽  
pp. 193896552110335
Author(s):  
John W. O’Neill ◽  
Jihwan Yeon
Keyword(s):  
Service Providers ◽  
Comprehensive Analysis ◽  
Competitive Market ◽  
Substitution Effects ◽  
Short Term ◽  
Hotel Performance ◽  
The World ◽  
Different Types ◽  
Location Type ◽  
The Impact

In recent years, short-term rental platforms in the lodging sector, including Airbnb, VRBO, and HomeAway, have received extensive attention and emerged as potentially alternative suppliers of services traditionally provided by established commercial accommodation providers, that is, hotels. Short-term rentals have dramatically increased the available supply of rooms for visitors to multiple international destinations, potentially siphoning demand away from hotels to short-term rental businesses. In a competitive market, an increase in supply with constant demand would negatively influence incumbent service providers. In this article, we examine the substitution effects of short-term rental supply on hotel performance in different cities around the world. Specifically, we comprehensively investigate the substitution effects of short-term rental supply on hotel performance based on hotel class, location type, and region. Furthermore, we segment the short-term rental supply based on its types of accommodations, that is, shared rooms, private rooms, and entire homes, and both examine and quantify the differential effects of these types of short-term rentals on different types of hotels. This study offers a comprehensive analysis regarding the impact of multiple short-term rental platforms on hotel performance and offers both conceptual and practical insights regarding the nature and extent of the effects that were identified.

Safety of vitamin E-infused highwall liners for routine use in primary total hip arthroplasty: single centre, short-term follow-up of 1221 cases

2020 ◽  
pp. 112070002096964
Author(s):  
Kirill Gromov ◽  
Nanna H Sillesen ◽  
Thomas Kallemose ◽  
Henrik Husted ◽  
Henrik Malchau ◽  
...  
Keyword(s):  
Patient Safety ◽  
Vitamin E ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Single Centre ◽  
Short Term ◽  
Total Hip ◽  
Arthroplasty Registry ◽  
Primary Total Hip Arthroplasty

Background: Introduction of new implants should be monitored closely to capture any signs of compromising patient safety. Vitamin E infused highly-crosslinked polyethylene liners (VEPE) offer the potential for reduced wear. Highwall liners have been hypothesised to result in increased wear and potential liner fractures. The aim of this study was to determine the 3–7-year follow-up of highwall VEPE for primary total hip arthroplasty (THA), focusing on liner-related complications. Methods: We included 1221 consecutive THA operations from July 2010 to May 2014 with minimum follow-up of 3 (3.1–6.8) years Data collected included demographics, implant data, complications, reoperations, and deaths. Data were cross-referenced with the Danish Hip Arthroplasty Registry in order to ensure validity and completeness. Acetabular shell position was measured using Martell Hip Analysis Suite in a subgroup of 931 THAs. Results: Cumulative stem revision and shell revision at 3-year follow-up was 3.4% and 0.4% respectively. There were no revisions due to liner failure. Reason for revision included 11 dislocations, 15 soft-tissue revisions for infection, 44 stem revisions of which 34 were periprosthetic fractures and 13 shell revisions of which 6 were combined shell and stem revisions. Conclusion: Early follow-up of VEPE liners for primary THA have not shown any revisions associated with liner failure. Continued monitoring of new materials are necessary to capture any signs of compromised patient safety.

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